| NPI | 1194776930 |
|---|---|
| Doing Business As | PINEDALE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | LORRAINE DIANE GATZKE CFO 307-276-4451 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2011-02-10 |