| NPI | 1144732736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN TATTERSALL President 307-413-0437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: WY 30955) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2018-10-17 |