| NPI | 1164671772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M. CALANTHE WILSON-PANT Member/Manager 406-782-1572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 8207) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-18 |