| NPI | 1720296130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY L CARTER Billing Manager 307-778-2860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WY 6491A) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2008-04-20 |