| NPI | 1467827774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD M CAMPBELL Sole Owner 307-532-1804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR0022404) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2015-12-11 |