Provider Demographics
NPI:1558040766
Name:HOSKINSON HEALTH & WELLNESS CLINIC, LLC
Entity Type:Organization
Organization Name:HOSKINSON HEALTH & WELLNESS CLINIC, LLC
Other - Org Name:HOSKINSON HEALING THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER, CHIEF MEDICAL OFFI
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:307-387-9850
Mailing Address - Street 1:201 W LAKEWAY ROAD
Mailing Address - Street 2:STE 700
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-6346
Mailing Address - Country:US
Mailing Address - Phone:307-387-9850
Mailing Address - Fax:307-987-9890
Practice Address - Street 1:201 W LAKEWAY ROAD
Practice Address - Street 2:STE 700
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-6346
Practice Address - Country:US
Practice Address - Phone:307-387-9850
Practice Address - Fax:307-987-9890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty