| NPI | 1043548019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKATAPERUMAL R CHANDRASEKARAN Owner 307-324-2294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WY 2812A) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |