Mountain Lodge Llc

Specialty details in registry · Douglas, WY

Call (307) 358-1897 Directions

At a glance

1110 Birch St, Douglas, WY 82633-2761

NPPES record updated Feb 12, 2018. Public records can lag behind changes at a practice.

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Are you accepting new patients?
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Insurance participation and appointment availability are not established by these public records.

Practice location

1110 Birch St
Douglas, WY 82633-2761

Professional details: NPI, taxonomy & registry record

NPI1437659877

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 310400000X
Enumeration date: Feb 12, 2018
Record updated: Feb 12, 2018

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

310400000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1110 Birch St
Douglas, WY 82633-2761

Phone: (307) 358-1897

Mailing address

1110 BIRCH ST

DOUGLAS, WY 826332761

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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