| NPI | 1922320910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA ROBINSON Credentialing Coordinator 307-335-5964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0904X Clinic/Center, Public Health, Federal (Licence: WY 19751) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |