| NPI | 1619413044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LEE WALBY Manager 307-206-4990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WY 10678A) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |