| Organization Name: | THREE RIVERS CLINIC LLC |
| NPI Number: | 1851425789 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHERRY KERR (ADMIN) |
| Mailing Address: | 16 Railway Ave Three Forks |
| State: | MT US |
| Postal Code: | 597521078 |
| Phone Number: | 4062853251 |
| Fax Number: | 4062856742 |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 10/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 29346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |