| NPI | 1740523521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG WILLARD MCCARTY Managing Partner 307-696-5053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 7686A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 7680A) |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2013-03-31 |