| NPI | 1659713048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANNA MARJO SMITH Pharmacist 307-672-1936 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WY 3665) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2013-07-25 |