| NPI | 1972725182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M GROSSO President 406-245-3238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2024-03-20 |