| NPI | 1972340446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CHARLES DUCHSCHERE Registered Agent 406-747-0455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-07-11 |