| NPI | 1811369630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARRE FISK Cbo Manager 307-688-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2015-10-21 |