NPI | 1215180898 |
---|---|
Entity Type | Organization |
Authorized Contact | HELEN D IAMS Owner 307-514-4041 |
Organization Subpart ? | No |
Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: WY 7107A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 7107A) |
Enumeration Date | 2008-10-28 |
Last Update Date | 2008-10-28 |