| NPI | 1639389281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA J LEONARDI Business Manager 307-332-5508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WY 106415100) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |