| Organization Name: | ROCKY BOY HEALTH CLINIC |
| NPI Number: | 1952554578 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY ELAINE CORCORAN (DIABETES COORDINATOR) |
| Mailing Address: | Rr 1 Box 664 Box Elder |
| State: | MT US |
| Postal Code: | 595219797 |
| Phone Number: | 4063954064 |
| Fax Number: | 4063954418 |
| NPI Enumeration Date: | 10/28/2008 |
| NPI Last Update Date: | 10/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | RN20314 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |