| NPI | 1669505004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON S OLSEN Orthopedic Surgeon 307-789-0096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-03-03 |