Healthcare Provider Details

I. General information

NPI: 1902181563
Provider Name (Legal Business Name): PEAK HEALTH AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W MAIN ST
BELGRADE MT
59714-3847
US

IV. Provider business mailing address

403 W MAIN ST
BELGRADE MT
59714-3847
US

V. Phone/Fax

Practice location:
  • Phone: 406-388-8708
  • Fax:
Mailing address:
  • Phone: 406-388-8708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number11301
License Number StateMT

VIII. Authorized Official

Name: DAVID STERN
Title or Position: OWNER/MD
Credential: MD
Phone: 406-388-8708