Facial Plastic & Reconstructive Surgery Montana Pc

NPI 1134286883 - Clinic/Center - 261QS0112X

NPI Details
NPI 1134286883
Enumeration Date 01/02/2007
Last Updated 03/30/2011
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CLARK O CLARK
Position DIRECTOR OWNER
Phone (406) 549-6600
Fax (406) 549-1511
Practice Location
805 S RESERVE ST
MISSOULA MT, 59801-2104, US
Phone (406) 549-6600
Fax (406) 549-1511
Business Location
805 S RESERVE ST
MISSOULA MT, 59801-2104, US
Phone (406) 549-6600
Fax (406) 549-1511
Toxanomy
Taxonomy Code 261QS0112X
License State Montana
License Number 11479
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According to our database, Facial Plastic & Reconstructive Surgery Montana Pc NPI is 1134286883, taxonomy code is 261QS0112X and license number is 11479, license state is located at Montana. Facial Plastic & Reconstructive Surgery Montana Pc physically located at 805 S Reserve St, Missoula MT, 59801-2104. NPI Number 1033115704 has the healthcare provider type.

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1134286883 NPI number is provided on an as is basis without warranty of any kind. 1134286883 is maintained by the National Plan & Provider Enumeration System. The contents of Facial Plastic & Reconstructive Surgery Montana Pc are for informational purposes only.