| NPI | 1598843922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS D WAGNER President 406-360-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT RN 16715) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |