| NPI | 1134201957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S DOUGLAS GEORGE Owner 307-734-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2013-01-14 |