| NPI | 1295254621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTNE CASTERLINE Sole Member 406-228-8212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MT CHI-CHI-LIC-4542) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-03-31 |