| NPI | 1801584503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY DORR COO 307-217-0467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-09 |