| NPI | 1104943489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE BALL HORTON Office Manager Corp Secretary 406-251-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MT 3719) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2008-01-07 |