| NPI | 1417193053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE M ALBRIGHT Owner 406-961-3244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MT 09-14-10200) |
| Enumeration Date | 2009-01-04 |
| Last Update Date | 2009-01-04 |