| NPI | 1659566974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN KIM MAYCOCK President 307-682-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WY 586 WY) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2008-03-13 |