| NPI | 1063679124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA A. KIPLING Business Office Manager 406-338-6369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MT AC0008) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2009-01-06 |