| Base Vitality Pllc | |
|
103 Ponderosa Ln Kalispell MT 59901-6833 | |
| (406) 220-5058 | |
| Not Available |
| Full Name | Base Vitality Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 103 Ponderosa Ln, Kalispell, Montana |
| Authorized Official Name and Position | Andrea L Emde (OWNER) |
| Authorized Official Contact | 3609415672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Base Vitality Pllc 103 Ponderosa Ln Kalispell MT 59901-6833 Ph: (406) 220-5058 | Base Vitality Pllc 103 Ponderosa Ln Kalispell MT 59901-6833 Ph: (406) 220-5058 |
| NPI Number | 1114727237 |
|---|---|
| Provider Enumeration Date | 03/17/2025 |
| Last Update Date | 03/17/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114727237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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