| NPI | 1750036174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE GOODMAN Authorized Official 406-253-3886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2024-10-23 |