| NPI | 1942442421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD A OCONNELL Owner/Operator 406-490-1359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: MT 1281) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |