NPI | 1518902881 |
---|---|
Former Legal Business Name | DEFRESE OSTEOPATHIC CLINIC, INC. |
Entity Type | Organization |
Authorized Contact | DHARMA ROSE President 406-745-0845 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MT MED-PHYS-LIC-53457) |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: IN 02001899) |
Enumeration Date | 2006-06-19 |
Last Update Date | 2024-02-10 |