| Missoula Osteopathic Clinic, Llc | |
|
341 W Pine St Missoula MT 59802-4119 | |
| (406) 327-0269 | |
| (406) 327-0264 |
| Full Name | Missoula Osteopathic Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 341 W Pine St, Missoula, Montana |
| Authorized Official Name and Position | Sam Aron Wallace (OWNER/PHYSICIAN) |
| Authorized Official Contact | 4063270269 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Missoula Osteopathic Clinic, Llc 341 W Pine St Missoula MT 59802-4119 Ph: (406) 327-0269 | Missoula Osteopathic Clinic, Llc 341 W Pine St Missoula MT 59802-4119 Ph: (406) 327-0269 |
| NPI Number | 1326487430 |
|---|---|
| Provider Enumeration Date | 06/21/2013 |
| Last Update Date | 11/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326487430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MED-PHYS-LIC-8667 (Montana) | Primary |
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