| NPI | 1508808239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MCRAE President 307-635-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2022-10-03 |