| NPI | 1598766826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARK POULSEN Administrator 406-799-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center Radiology (Licence: MT 9758) |
| Additional Taxonomies | 261QM1200X Clinic/Center Magnetic Resonance Imaging (MRI) (Licence: MT 9758) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2011-08-17 |