NPI | 1669041760 |
---|---|
Entity Type | Organization |
Authorized Contact | GRIFFIN MYERS Cmo 307-264-2085 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
Additional Taxonomies | 1041C0700X Social Worker Clinical |
207Q00000X Family Medicine | |
207R00000X Internal Medicine | |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner Family | |
Enumeration Date | 2021-06-22 |
Last Update Date | 2023-06-30 |