| NPI | 1063984813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIFFIN MYERS Cmo 307-264-2085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2023-06-29 |