| NPI | 1679823439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MILLER Enrollment Specialist 406-447-2823 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |