| NPI | 1003220096 |
|---|---|
| Former Legal Business Name | BRAIN INJURY ASSOCIATION OF WYOMING |
| Entity Type | Organization |
| Authorized Contact | DAWN M LACKO Executive Director 307-473-1767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2014-06-17 |