| NPI | 1932299690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN L HEDGES CEO 307-332-2941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WY 0823410001) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-04-03 |