Optimal Performance Medicine, Llc | |
611 E Carlson St Ste 117c Cheyenne WY 82009-4311 | |
(307) 514-0510 | |
Not Available |
Full Name | Optimal Performance Medicine, Llc |
---|---|
Speciality | Internal Medicine |
Location | 611 E Carlson St Ste 117c, Cheyenne, Wyoming |
Authorized Official Name and Position | Paul Jordan Washburn (DIRECTOR/OWNER) |
Authorized Official Contact | 9705189394 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Optimal Performance Medicine, Llc 611 E Carlson St Ste 117c Cheyenne WY 82009-4311 Ph: (307) 514-0510 | Optimal Performance Medicine, Llc 611 E Carlson St Ste 117c Cheyenne WY 82009-4311 Ph: (307) 514-0510 |
NPI Number | 1659911550 |
---|---|
Provider Enumeration Date | 01/09/2020 |
Last Update Date | 01/09/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659911550 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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