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310 Wendell Ave Suite 103 Lewistown MT 59457-2267 | |
| (406) 535-1480 | |
| (406) 535-1481 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 310 Wendell Ave, Lewistown, Montana |
| Authorized Official Name and Position | Corina J Cook (MANAGER) |
| Authorized Official Contact | 4065351484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
310 Wendell Ave Suite 103 Lewistown MT 59457-2267 Ph: (406) 535-1480 | 310 Wendell Ave Suite 103 Lewistown MT 59457-2267 Ph: (406) 535-1480 |
| NPI Number | 1801968524 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 06/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801968524 | NPI | - | NPPES |
| CG4190 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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