| NPI | 1386840429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY S PURIFOY Owner Provider 307-634-6095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WY 17632.0272) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |