| NPI | 1902982051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP LOWE President 307-733-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WY 6215A) |
| Additional Taxonomies | 2088P0231X (Licence: WY 6215A) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2015-08-26 |