| NPI | 1285006163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KIHLE Business Manager 307-234-3635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY PT653) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |