| NPI | 1831450394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD ZIMMERMAN Owner/Operator 307-347-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WY 28919) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |