| NPI | 1154420768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN J SNYDER Owner 307-672-0763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 4286A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 15246.316) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |