| NPI | 1326679432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE KAY NEWTON Office Manager 307-587-2139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 208600000X Surgery |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-06-16 |