| NPI | 1215561378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON J EVANS Owner 307-372-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |