| NPI | 1770543779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK J STIBEL President 406-452-9507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 470) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MT 568) |
| 152W00000X Optometrist (Licence: MT 794) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2011-05-02 |