Provider Demographics
NPI:1649519554
Name:AMY P TORTORICH PC
Entity type:Organization
Organization Name:AMY P TORTORICH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TORTORICH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:307-459-2626
Mailing Address - Street 1:PO BOX 4217
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-4217
Mailing Address - Country:US
Mailing Address - Phone:307-222-9141
Mailing Address - Fax:
Practice Address - Street 1:1916 HOUSE AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3720
Practice Address - Country:US
Practice Address - Phone:307-459-2626
Practice Address - Fax:307-459-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY8534A207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1568654911OtherMEDICARE NPI
WY1568654911OtherMEDICARE NPI