| 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 |