| NPI | 1972832806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON BRUCE WATERS Co Owner 307-371-1241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport (Licence: WY 68) |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2010-05-04 |