NPI | 1801273636 |
---|---|
Entity Type | Organization |
Authorized Contact | JEREMIAH L WATT Business Owner 406-781-3323 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MT 1670537) |
Enumeration Date | 2015-04-30 |
Last Update Date | 2015-07-15 |