| NPI | 1053554162 |
|---|---|
| Doing Business As | JACKSON HOLE CENTER FOR PREVENTIVE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ROBERT D. LANGER Managing Member 307-733-4452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WY 7777A) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-04-20 |