| NPI | 1417048810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN STUTTE External Financial Controller 307-577-2767 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2008-01-16 |