| NPI | 1811169915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN M WIGNESS Dr. 406-862-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MT 1048) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2013-04-03 |