Organization · NPI-2

Cody Clinic

Internal Medicine · Cody, WY

NPI number1104422237
StatusActive
Last updated in NPPESFeb 17, 2021

Details

NPI
1104422237
Entity type
Organization (NPI-2)
Legal business name
Cody Clinic
Organization subpart
No
Enumeration date
Dec 4, 2020
Certification date
Feb 17, 2021
Last updated
Feb 17, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

2107 Sheridan Avenue
Cody, WY 82414

Phone 307-586-5303

Mailing address

Po Box 727
Cody, WY 82414-0727

Phone 307-586-5303

Authorized official

Judd L Larowe
President
3075865303

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