| NPI | 1477265544 |
|---|---|
| Former Legal Business Name | UNTO L.L.C. |
| Entity Type | Organization |
| Authorized Contact | MICHELLE RENEE PARKER Provider 307-680-3761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2022-12-20 |