| NPI | 1083626832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK C DEIBERT President 406-586-8029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MT 8221) |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2011-10-27 |