| NPI | 1508312059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA ISABELLA KRUMBECK Owner 406-552-5041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: MT AHC-NAT-LIC-811) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| 261QP2300X Clinic/Center Primary Care (Licence: MT AHC-NAT-LIC-811) | |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2021-02-26 |