JACKSON HOLE MEDICAL CLINIC, LLC
Osteopathic Medicine at Hwy 89, Jackson, WY

License number
Wyoming 5551A
Category
Osteopathic Medicine
Type
Allergy
Owner
Name: FRANKLIN RIVERS JR. MD
Title: OWNER
Phone: (307) 739-8999
Address
Address
1415 Hwy 89 S., Jackson, WY 83001
National Provider ID: 1699817668
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Jackson Hole Medical Clinic, LLC

Jackson, WY

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Jackson Hole Medical Clinic
Registration:
Dec 21, 1998
Inactive since:
Feb 9, 2011
Phone:
(307) 739-8999 (Phone)
Addresses:
PO Box 8640, Jackson, WY 83002 (Physical)
988 S Us Hwy 89, Jackson, WY 83001
State ID:
1998-000340309
Business type:
Limited Liability Company - Domestic
Expiration:
Expires-12/21/2028
Owner:
Franklin Rivers (Owner)

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