NPI | 1831347095 |
---|---|
Entity Type | Organization |
Authorized Contact | ROCHELLE DAWN STARK M.D. / Owner 307-460-2055 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: WY 1040 (temporary)) |
Enumeration Date | 2008-08-29 |
Last Update Date | 2008-08-29 |