| NPI | 1619054921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERMIT RAGAIN Owner 406-345-8408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: MT 7438) |
| Additional Taxonomies | 2085N0700X (Licence: MT 7438) |
| 2085N0904X (Licence: MT 7438) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: MT 7438) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 7438) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MT 7438) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MT 7438) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-01-02 |