| NPI | 1861523649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK GEDLAMAN CEO 406-892-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 10336) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MT 312) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-08-26 |