| NPI | 1447293113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW TAYLOR DODDS Owner 307-237-2511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WY 06-188) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-11-19 |