NPI | 1942193107 |
---|---|
Doing Business As | SAGE AND STONE WELLNESS |
Entity Type | Organization |
Authorized Contact | CLINTON J TRAYLOR Owner 307-389-8387 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2025-05-29 |
Last Update Date | 2025-09-08 |