| NPI | 1235705716 |
|---|---|
| Doing Business As | PARK CITY DERMATOLOGY, ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | LEANNE MCMAHON Cpa 406-439-0607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-06-03 |