| NPI | 1770948929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN EDWARD LATTER Owner 406-755-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2021-12-17 |