| NPI | 1386743169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L HEGNER Medical Practice Manager 307-634-9238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: WY 53D0945915) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |