| NPI | 1497759955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GAGNON Executive Director 406-237-5905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MT 9728) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2012-10-08 |