Montana Heart Angio Lab LLC
Clinical Medical Laboratory in Missoula, MT. Organization (NPI-2).
NPI number1619007101
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1619007101
- Entity type
- Organization (NPI-2)
- Legal business name
- Montana Heart Angio Lab LLC
- Organization subpart
- No
- Enumeration date
- Mar 6, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | 71253 | MT | Yes |
Practice location
2827 Fort Missoula RdMissoula, MT 59804-7408
Phone 406-327-4614 · Fax 406-327-4679
Mailing address
2827 Fort Missoula RdMissoula, MT 59804-7408
Phone 406-327-4614 · Fax 406-327-4679
Authorized official
John Dague
Director
4063274131
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