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 |