| 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 |