| Jiivana Integrative Health Pllc | |
|
825 W. Kent St. Missoula MT 59801-6619 | |
| (406) 546-3043 | |
| Not Available |
| Full Name | Jiivana Integrative Health Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 825 W. Kent St., Missoula, Montana |
| Authorized Official Name and Position | Laura Marx (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 4065463043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jiivana Integrative Health Pllc 825 W. Kent St. Missoula MT 59801-6619 Ph: (406) 546-3043 | Jiivana Integrative Health Pllc 825 W. Kent St. Missoula MT 59801-6619 Ph: (406) 546-3043 |
| NPI Number | 1497059638 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 01/03/2011 |
| Medicare PECOS PAC ID | 9537340708 |
|---|---|
| Medicare Enrollment ID | O20110221000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497059638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | APN22313 (Montana) | Primary |
| Provider Name | Laura E Marx |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366548604 PECOS PAC ID: 6507991304 Enrollment ID: I20100319000455 |
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