institution
Brent Blue Md
Urgent Care Clinic/Center in Jackson, Wyoming
NPI 1356556518

Brent Blue Md is a Urgent Care Clinic/Center based in Jackson, WY and is specialized in Urgent Care. Brent Blue Md practices in Jackson, WY. The NPI Number for Brent Blue Md is 1356556518 and holds a License No. 3416A (Wyoming).

The current practice location address for Brent Blue Md is 982 W Broadway, Jackson, WY and can be reached out via phone at 307-733-8002 and via fax at 307-733-0032.

Location: 982 W Broadway, Jackson, WY, 83002-5240
institution
Provider Profile Details
NPI Number
1356556518
Provider Name
Brent Blue Md
Credential
Provider Entity Type
Organization
Address
982 W Broadway, Jackson, WY, 83002-5240
Phone Number
307-733-8002
Fax Number
307-733-0032
Provider Enumeration Date
05/11/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
218545001 01 WY USDOL CLINIC NUMBER
109651600 05 WY
institution
Provider Business Practice Location Address Details
Address
982 W Broadway
City
State
Zip
83001
Phone Number
307-733-8002
Fax Number
307-733-0032
person
Provider Business Mailing Address Details
Address
982 W Broadway
City
State
Zip
83001
Phone Number
307-733-8002
Fax Number
307-733-0032
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Urgent Care
Taxonomy
License No.
3416A (Wyoming)
Definition
Definition to come...
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