| NPI | 1245505890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM A FITZGERALD Executive Vice President 307-688-1520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07000830A) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |