Develpmental Pediatric Services | |
915 S David St Casper WY 82601-3737 | |
(307) 472-3769 | |
(307) 472-3607 |
Full Name | Develpmental Pediatric Services |
---|---|
Speciality | Counselor |
Location | 915 S David St, Casper, Wyoming |
Authorized Official Name and Position | Diane Rose Edwards (OWNER) |
Authorized Official Contact | 3074723769 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Develpmental Pediatric Services 915 S David St Casper WY 82601-3737 Ph: (307) 472-3769 | Develpmental Pediatric Services 915 S David St Casper WY 82601-3737 Ph: (307) 472-3769 |
NPI Number | 1538366075 |
---|---|
Provider Enumeration Date | 06/28/2007 |
Last Update Date | 07/27/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538366075 | NPI | - | NPPES |
112255000 | Medicaid | WY | |
1003982141 | Other | WY | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
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