| NPI | 1063786077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLYNN SHERICK President 406-721-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MT 88) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MT 88) |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: MT 88) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: MT 88) | |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2014-05-06 |