| NPI | 1629737259 |
|---|---|
| Other Name | CHEYENNE CHILDREN'S CLINIC (LARAMIE ST) |
| Entity Type | Organization |
| Authorized Contact | BRAD WHITE Administrator Of Revenue 307-633-6198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2026-07-03 |