| NPI | 1104097351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RICHARD JAHNKE Doctor Owner 406-755-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain (Licence: MT 10947) |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2020-04-06 |