| NPI | 1952797243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD HENRY CREEKMORE Practitioner/Managing Member 406-529-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: MT 2015-mss-gen-00092) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2022-03-02 |