| NPI | 1215135025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDRASHEKAR YESHLUR President 307-362-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WY 6946A) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |