NPI | 1326487430 |
---|---|
Entity Type | Organization |
Authorized Contact | SAM ARON WALLACE Owner/Physician 406-327-0269 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-8667) |
Enumeration Date | 2013-06-21 |
Last Update Date | 2022-11-10 |