| Medical Psychotherapy Pc | |
|
140 E Broadway Ave Jackson WY 83001-8632 | |
| (307) 201-1254 | |
| Not Available |
| Full Name | Medical Psychotherapy Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 140 E Broadway Ave, Jackson, Wyoming |
| Authorized Official Name and Position | Philip W Girling (OWNER/ PHYSICIAN) |
| Authorized Official Contact | 3072011254 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Psychotherapy Pc Po Box 589 Jackson WY 83001-0589 Ph: (307) 201-1254 | Medical Psychotherapy Pc 140 E Broadway Ave Jackson WY 83001-8632 Ph: (307) 201-1254 |
| NPI Number | 1417904095 |
|---|---|
| Provider Enumeration Date | 05/28/2006 |
| Last Update Date | 04/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417904095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M-8621 (Idaho) | Primary |
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