| Kelly Ewalt, Inc | |
|
305 1st Ave W Columbia Falls MT 59912-3625 | |
| (406) 249-9153 | |
| (406) 892-4606 |
| Full Name | Kelly Ewalt, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 305 1st Ave W, Columbia Falls, Montana |
| Authorized Official Name and Position | Kelly Ewalt (OWNER) |
| Authorized Official Contact | 4062499153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Ewalt, Inc 305 1st Ave W Columbia Falls MT 59912-3625 Ph: (406) 249-9153 | Kelly Ewalt, Inc 305 1st Ave W Columbia Falls MT 59912-3625 Ph: (406) 249-9153 |
| NPI Number | 1114770591 |
|---|---|
| Provider Enumeration Date | 04/08/2024 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114770591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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