| NPI | 1477192243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SALTERS Medical Staff Services 307-578-2486 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2025-01-27 |