Provider Demographics
NPI:1477265544
Name:UNTO L.L.C.
Entity Type:Organization
Organization Name:UNTO L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-FNP-BC
Authorized Official - Phone:307-680-3761
Mailing Address - Street 1:1590 SUGARLAND DR # 161
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5776
Mailing Address - Country:US
Mailing Address - Phone:307-752-0221
Mailing Address - Fax:
Practice Address - Street 1:395 HARVEY LN
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-9129
Practice Address - Country:US
Practice Address - Phone:307-680-3761
Practice Address - Fax:307-429-5654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty