Organization Name: | OCF WEST GROUP INC |
NPI Number: | 1750610556 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN E MOORE (OWNER) |
Mailing Address: | 307 E Park Ave Anaconda |
State: | MT US |
Postal Code: | 597112320 |
Phone Number: | 4065634386 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2009 |
NPI Last Update Date: | 12/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 7622 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |