| NPI | 1730335423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON P HAACK Owner 307-789-8721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2013-10-24 |