Provider Demographics
NPI:1225917610
Name:HIGH POINT WELLNESS, LLC
Entity type:Organization
Organization Name:HIGH POINT WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP, PEDIATRIC NP
Authorized Official - Phone:307-212-6082
Mailing Address - Street 1:1208 HILLTOP DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5858
Mailing Address - Country:US
Mailing Address - Phone:307-679-7774
Mailing Address - Fax:307-224-2128
Practice Address - Street 1:1208 HILLTOP DR STE 103
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5858
Practice Address - Country:US
Practice Address - Phone:307-212-6082
Practice Address - Fax:307-224-2128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH POINT WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY53D2325095OtherCLIA ID #
WY1730730771OtherCLIA ID # 53D2325095