| NPI | 1679851570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS L BUCKNER Physician / Owner 307-333-6567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2024-06-20 |