NPI | 1063951762 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMRA MUNSELL Revenue Cycle Manager 307-233-6092 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2017-02-15 |
Last Update Date | 2019-07-15 |