| NPI | 1518947589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA SUAZO Director Of Human Resources 307-745-8851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WY 06018) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-01-21 |