Provider Demographics
NPI:1518674514
Name:ZORUMSKE FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:ZORUMSKE FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ORUM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:307-752-8814
Mailing Address - Street 1:51 COFFEEN AVE STE 101-278
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-4872
Mailing Address - Country:US
Mailing Address - Phone:307-752-8814
Mailing Address - Fax:307-460-7409
Practice Address - Street 1:39 N SCOTT ST STE 21
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-6363
Practice Address - Country:US
Practice Address - Phone:307-429-1202
Practice Address - Fax:307-288-6353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty