NPI | 1932958501 |
---|---|
Entity Type | Organization |
Authorized Contact | SABRINA GIBSON CFO 307-277-1006 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2024-05-16 |
Last Update Date | 2024-05-16 |