Facts
- Status
- A
- Type
- Individual
- Enumeration date
- 2017-03-21
- Last updated
- 2017-03-21
Specialties
Licenses
- License MT
- OTP-OT-LIC-4734
Location
- Practice location
- 600 STATE HWY 91 SOUTH
- City
- DILLON MT
- Postal code
- 59725
- Phone
- 406-683-3096
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.