NPI 1033437132

Ninak INC.

Organisation Family Medicine Physician Jackson, WY

Practice location

Address: 170 E Broadway, Jackson, WY 82001-9906
Phone: (307) 203-9239
Mailing address: 23371 Mulholland Dr STE 327, Woodland Hills, CA 91364-2734

Authorised official

Name: Michael John Lee
Title: Family Practice
Phone: (307) 203-9239

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 6084A (WY)

Other Family Medicine providers in Wyoming →

Registry record

NPI: 1033437132
Entity type: Organization
NPI issued: 13 May 2010
Record last updated: 13 May 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.