| Doctor Name: | JACK H AVERY |
| NPI Number: | 1962586370 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RT (R) (MRI)(QM)(CT) |
| License Number: | 1019 |
| Business Practice Address: | 3510 Ptarmigan Ln Helena, MT - 596020553 |
| Business Phone Number: | 4064493750 |
| Business Fax Number: | 4064493752 |
| Mailing Address: | Po Box 5179, HELENA |
| State: | MT |
| Postal Code: | 596045179 |
| Phone Number: | 4064493750 |
| Fax Number: | 4064493752 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 11/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 247100000X |
| License Number: | 1019 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |