| NPI | 1740625854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARRAN L BEDWELL VP Quality & Compliance 307-324-8383 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2013-05-02 |