NPI | 1649725532 |
---|---|
Former Legal Business Name | POWDER RIVER SURGERY CENTER |
Entity Type | Organization |
Authorized Contact | DALTON HUBER Chief Financial Officer 307-688-1523 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WY P-905) |
Enumeration Date | 2016-08-20 |
Last Update Date | 2016-08-20 |