| NPI | 1427545938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY MARIE FROST Owner 307-764-5470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2020-02-09 |