| NPI | 1093002412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA J MASON President 307-201-1696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 263300970) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2016-06-21 |