| NPI | 1386639797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN D BASTA Partner 307-263-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging |
| 2085R0202X Radiology Diagnostic Radiology | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2023-03-20 |