| NPI | 1831675479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON KELLEY Physician 307-763-4556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: WY 779) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |