| NPI | 1336836949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIFFIN MYERS Cmo 307-264-2085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-06-30 |