| NPI | 1013489095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WAYNE FALLEY Owner 406-431-7332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2019-01-01 |
| Last Update Date | 2019-04-03 |