| NPI | 1205175700 |
|---|---|
| Doing Business As | BROADWATER WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | JENNY CLOWES CEO 406-266-3186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2023-08-02 |