| NPI | 1114695731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A BROE, CPC, CPPM, OCS Billing Director 406-541-3806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2024-02-12 |