| NPI | 1164599379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ROBERTSON Administrator 307-472-8781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 35-2-904) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2008-07-07 |