| Organization Name: | MISSION VALLEY HEALTH CLINIC, INCORPORATED |
| NPI Number: | 1982659652 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SABRINA JANE CASTOR (OFFICE MANAGER) |
| Mailing Address: | 35773 Airport Rd St Ignatius |
| State: | MT US |
| Postal Code: | 598659001 |
| Phone Number: | 4067458765 |
| Fax Number: | |
| NPI Enumeration Date: | 05/23/2006 |
| NPI Last Update Date: | 03/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 145 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |