| NPI | 1356612519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RICHARD ECKLUND President 406-577-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: MT 8582) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2012-09-13 |