| NPI | 1770990426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY D KRAUS Clinical Manager 307-856-4959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WY 261Q00000X) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2014-07-15 |