| NPI | 1306826177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY ROHDE Administrator 307-587-2139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WY 06014) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2022-11-16 |