| Doctor Name: | TIMOTHY ROSETTE |
| NPI Number: | 1851700025 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 535 Clinic Rd E Box Elder, MT - 595218826 |
| Business Phone Number: | 4063954486 |
| Business Fax Number: | 4063954138 |
| Mailing Address: | 535 Clinic Rd E, BOX ELDER |
| State: | MT |
| Postal Code: | 595218826 |
| Phone Number: | 4063954486 |
| Fax Number: | 4063954138 |
| NPI Enumeration Date: | 08/12/2014 |
| NPI Last Update Date: | 08/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |