NPI | 1174722540 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHLEEN RUH TRAPP Owner 406-266-3224 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MT 10909) |
Enumeration Date | 2007-07-16 |
Last Update Date | 2014-01-29 |