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NPI 1316783673

OrganizationActive

307 Longevity PC

NPI 1316783673 · Clinic/Center · Cody, WY

Provider details

NPI number: 1316783673
Entity type: Organization
Primary specialty: Clinic/CenterAmbulatory Health Care Facilities
Authorized official: Christopher Thoma, Owner

Practice location

1120 Beck Ave

Cody, WY 82414-3624

Phone: (307) 527-0355

Fax: (307) 527-0360

More WY providers

Mailing address

Po Box 308

Wapiti, WY 82450-0308

Registry dates

Enumerated: 2024-07-06
Last updated: 2024-07-06

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

307 Longevity PC — NPI 1316783673, Cody, WY | NPI Central