Healthcare Provider Details

I. General information

NPI: 1679759971
Provider Name (Legal Business Name): FAMILY HEALTH CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 NUCLEUS AVE
COLUMBIA FALLS MT
59912-4015
US

IV. Provider business mailing address

1287 BURNS WAY
KALISPELL MT
59901-3109
US

V. Phone/Fax

Practice location:
  • Phone: 406-751-6162
  • Fax:
Mailing address:
  • Phone: 406-751-6162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER H GILL
Title or Position: PRESIDENT
Credential: MD
Phone: 406-751-6162