Organization · Type 2 NPI
Clean Clinic Wyoming
Addiction Medicine (Family Medicine) Physician · Cheyenne, WY
NPI number
1548909153
Active
Practice location
1918 Thomes Ave
Cheyenne, WY 82001-3527
Mailing address
63 E 11400 S # 275
Sandy, UT 84070-6705
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Family Medicine) Physician Primary | 207QA0401X | None listed |
Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.
3 other providers at this address
About NPI 1548909153
Clean Clinic Wyoming's National Provider Identifier is 1548909153, issued on Jun 1, 2022. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Cheyenne, WY. The record was last updated on Feb 17, 2024.