| NPI | 1174879647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY J LAMBLIN Owner 307-332-9720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2017-10-12 |