NPI | 1982420311 |
---|---|
Entity Type | Organization |
Authorized Contact | DARNELL SIMPSON President 307-883-7246 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Additional Taxonomies | 207Q00000X Family Medicine |
208D00000X General Practice | |
Enumeration Date | 2024-12-02 |
Last Update Date | 2024-12-02 |