| NPI | 1477660447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN L EDWARDS Office Manager 307-687-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-07-27 |