| NPI | 1639150956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES G CLOUGH Owner President 406-761-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MT 75) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MT 122) |
| 225100000X Physical Therapist (Licence: MT 800PT) | |
| 225100000X Physical Therapist (Licence: MT 1558PT) | |
| 225100000X Physical Therapist (Licence: MT 1071PT) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2020-08-22 |