| NPI | 1417461732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL J MANGOLD Owner/Manager 406-543-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MT 174) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2018-11-28 |