| NPI | 1396570875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA GALVIN Owner 307-677-4649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-09-04 |