| NPI | 1912101973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANNE FISCHER Primary Physician 307-778-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2018-04-10 |