| NPI | 1053452094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRENT PAGE Principal 307-399-7276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WY 6261A) |
| Enumeration Date | 2007-02-11 |
| Last Update Date | 2020-08-22 |