| NPI | 1083264816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA LEA MONTAGUE Authorized Official 406-657-2061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-09-13 |