| NPI | 1326107137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE P PEASLEY Owner 307-322-3861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WY 5735A) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2020-08-22 |