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Evanston Clinic Corp

Evanston Clinic Corp is a health care provider in Brentwood, TN. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 107 N Main St, Lyman, WY 82937, US
Practice Location Phone307-787-3313
Practice Location Fax
Legal Business NameEVANSTON CLINIC CORP
Other Organization NameBRIDGER VALLEY FAMILY PRACTICE
Other Organization Name TypeDoing Business As Name
NPI ?1801084926
Entity TypeOrganization
Enumeration Date ? Oct 15, 2007
Last Update Date ? Oct 15, 2007
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Evanston Clinic Corp

SpecialtySpecializationLicenseLicense State
Family Medicine Wyoming

official-icon Authorized Official of Evanston Clinic Corp

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Evanston Clinic Corp's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Debbie T Brewer (MBA)
Authorized Official Title/PositionDIRECTOR OF PROVIDER ENROLLMENT
Authorized Official Phone Number615-465-7626