NPI | 1154420768 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSAN J SNYDER Owner 307-672-0763 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 15246.316) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 4286A) |
Enumeration Date | 2006-09-21 |
Last Update Date | 2025-09-11 |