| NPI | 1386153740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN A. TAHTA Physician 406-544-6438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MT 8664) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2018-06-16 |