| NAME |
LARAMIE VA MOBILE CLINIC |
| STATE |
WYOMING |
| STREET ADDR. 1 |
4750 HIGHWAY 130 |
| CITY |
LARAMIE |
| ZIP |
82070-9792 |
| OFFICIAL VA NAME |
LARAMIE VA MOBILE CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
LARAMIE VA MOBILE CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2015-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1922586692
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
442QD |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 2901 ARMORY ROAD
- CITY (CHANGED FROM): LARAMIE
- STATE (CHANGED FROM): WYOMING
- ZIP (CHANGED FROM): 82072-2937
|
