| NPI | 1972811420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL SIMMONS Office Manager 406-455-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MT 8726) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT APN13634) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2010-09-17 |