| NPI | 1770259418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY UNDERWOOD PFS Manager 307-688-1492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-08-23 |