| NPI | 1699874727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD R DICKEMORE Director 406-363-4214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MT 169) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-12-04 |