| NPI | 1932563939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON E. SMITH Owner 406-422-5905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: MT 33559) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2023-05-25 |