Healthcare Provider Details
I. General information
NPI: 1730998287
Provider Name (Legal Business Name): JEREMIAH MARK ZILKOSKI I
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1732 S 72ND ST W
BILLINGS MT
59106-3538
US
IV. Provider business mailing address
1995 OUTLOOK DR
BILLINGS MT
59105-4302
US
V. Phone/Fax
- Phone: 406-655-2100
- Fax:
- Phone: 406-208-3402
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: