| NPI | 1053884080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD PEW VP Of Operations 307-262-9410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208M00000X Hospitalist | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2024-06-12 |