| NPI | 1093902223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREE NINCEHELSER Office Manager 307-883-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WY 673) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WY 707) |
| 261Q00000X Clinic/Center (Licence: WY 673) | |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2010-11-24 |