| NPI | 1568708360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS K FORD President 406-465-5751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MT 6345139-002-WTH) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2013-01-30 |