| NPI | 1023174299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANTONE Acting CEO/Administrative Officer 307-332-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0904X Clinic/Center, Public Health, Federal |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2011-05-24 |