| NPI | 1104222330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OBRAD KOKANOVIC Owner 406-750-8202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WI 51767) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2015-01-27 |