| NPI | 1447535869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RANDALL MEALER Sole Shareholder 406-585-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MT 9651) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-10-17 |