| NPI | 1316204100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER JONES Owner 406-969-2468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MT 1236) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |