| NPI | 1164616504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WISE WIGGINS Physician/President 406-238-6190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MT 5109) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |