| NPI | 1407116338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RF JOHN HOLTZEN Owner 406-549-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MT 12580) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2025-04-22 |