NPI | 1770161432 |
---|---|
Entity Type | Organization |
Authorized Contact | GRIFFIN MYERS Cmo 307-264-2085 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2021-04-01 |
Last Update Date | 2023-06-29 |