| NPI | 1700042942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A. BECK Medical Director 307-680-3130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: WY PENDING) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2009-03-04 |