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1174993703
BODEE ALT
MISSOULA, MT
NPI
1174993703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MT 44583)
Enumeration Date
2015-09-24
Last Update Date
2015-10-01
Business Address
-- BODEE ALT APRN
500 W BROADWAY ST
MISSOULA, MT 59802-4008
Phone number: 406-543-7271
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Mailing Address
-- BODEE ALT APRN
PO BOX 12
LIBERTY LAKE, WA 99019-0012
Phone number: 406-543-7271
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