NPI | 1891817011 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENDA NARANJO Practice Manager 406-587-8478 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0131X (Licence: MT 129) |
Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
Enumeration Date | 2007-04-06 |
Last Update Date | 2025-05-30 |