| NPI | 1669426292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUES D BEVERIDGE President 307-332-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WY 6275A) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-10-24 |