| NPI | 1649055005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA COSGROVE Medical Director 406-577-7091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2024-01-24 |