Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI Number | 1710495700 |
| LBN Legal business name | WYOMING ENDOSCOPY CENTER LLC |
| Authorized official | SCOTT MCRAE - (OWNER/PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/12/2018 |
| Last updated | 10/03/2022 - About 4 years ago |
| Identifiers | n/a |
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WYOMING ENDOSCOPY CENTER LLC
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