| NPI | 1497833180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY R HASKINS Financial Manager 307-234-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WY 5197A) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WY 6725430001) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-08-23 |