| NPI | 1265710628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY LEE LOW Medical Director/CEO 307-213-9713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: WY 8705A) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2011-08-02 |