| NPI | 1144925462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEDRA HART Owner 307-696-7223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-09-28 |