Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI Number | 1407301872 |
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| LBN Legal business name | KALISPELL REGIONAL MEDICAL CENTER INC | ||||
| Authorized official | PAMELA ROBERTSON - (PRESIDENT/CHIEF EXECUTIVE OFFICER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 08/16/2016 | ||||
| Last updated | 10/04/2017 - About 9 years ago | ||||
| Identifiers |
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