Organization Name: | WESTERN MONTANA CLINIC PC |
NPI Number: | 1508033713 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOYCE E STEVENS (DIRECTOR) |
Mailing Address: | 401 W Pennsylvania St Anaconda |
State: | MT US |
Postal Code: | 597111931 |
Phone Number: | 4067215600 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2008 |
NPI Last Update Date: | 05/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |