| NPI | 1649239138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE WILLIAM OHOLLERAN Surgeon 307-637-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WY 6423A) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 16963) |
| 208600000X Surgery (Licence: CO 26688) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2011-09-09 |