| NPI | 1316783673 |
|---|---|
| Doing Business As | THE LEGACY CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER THOMA Owner 307-899-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-07-06 |
| Last Update Date | 2024-07-06 |