| NPI | 1619149226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WILLETTE Manager 307-234-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-03-24 |