| NPI | 1952881138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA CHRYSTINE HALL Authorized Official 406-250-8717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |