| NPI | 1487684213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA L CONVERSE Clinical Director 406-586-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MT 9618) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2010-01-05 |