THOMAS JOHN BASOLO

MISSOULA, MT
NPI1861270944
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT  BBH-LAC-LIC-64524)
Enumeration Date2023-09-19
Last Update Date2023-09-19
Business Address
THOMAS JOHN BASOLO LAC
2001 S RUSSELL ST
MISSOULA, MT 59801-6621
Phone number: 406-830-4167
Mailing Address
THOMAS JOHN BASOLO LAC
2001 S RUSSELL ST
MISSOULA, MT 59801-6621
Phone number: 406-830-4167
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