| NPI | 1093474983 |
|---|---|
| Other Name | PLASTIC RECONSTRUCTIVE & HAND SURGERY |
| Entity Type | Organization |
| Authorized Contact | BRAD WHITE Administrator Of Revenue 307-633-6198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2026-07-03 |