Mike Mahoney

Individual provider Active NPI Case Manager/Care Coordinator · Riverton, WY

NPI 1245463249 · NPPES record last updated Aug 25, 2009

Key facts

NPI
1245463249
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1502 E Pershing Ave
Riverton, WY 82501-3833
Phone
(307) 857-3555
NPI assigned
Aug 25, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1502 E Pershing Ave
Riverton, WY 82501-3833

Mailing address

1502 E Pershing Ave
Riverton, WY 82501-3833
Phone (307) 857-3555

Other providers in Riverton, WY

All providers in Riverton, WY · Case Manager/Care Coordinator in Wyoming

Sources for this page

Verify at the official NPI Registry.