Grand Ave Family Medicine
Grand Ave Family Medicine provides Family Medicine Physician services in Laramie, Wyoming. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
3236 E Grand Ave Ste DLaramie, WY 82070-5100
Phone: (970) 231-3498
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Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X |
|---|
Record details
| NPI number | 1437842390 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | John Jacobs — Owner · (970) 231-3498 |
| NPI enumerated | May 29, 2023 |
| Last updated in NPPES | May 29, 2023 |
| Certification date | May 27, 2023 |
| Mailing address | 3236 E Grand Ave Ste D, Laramie, WY 82070-5100 |
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