Provider Demographics
NPI:1740754043
Name:WYO EYE CARE LLC
Entity Type:Organization
Organization Name:WYO EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:208-547-7153
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:COKEVILLE
Mailing Address - State:WY
Mailing Address - Zip Code:83114-0085
Mailing Address - Country:US
Mailing Address - Phone:208-547-7153
Mailing Address - Fax:307-279-2050
Practice Address - Street 1:201 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5782
Practice Address - Country:US
Practice Address - Phone:307-362-3419
Practice Address - Fax:307-279-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-20
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty