| NPI | 1710221296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE G GRESHAM Owner 406-315-3503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 019237) |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2012-11-26 |