| NPI | 1285814723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALAN ANDERSON Owner / President 406-721-9996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MT 602) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-12-19 |