| NPI | 1750047031 |
|---|---|
| Doing Business As | CCMG HULETT CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARY LOU TATE CFO 307-688-1523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2021-12-30 |