| NPI | 1760505770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA NYBERG Administrative Assistant 406-496-3600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2012-01-13 |