Healthcare Provider Details

I. General information

NPI: 1972466993
Provider Name (Legal Business Name): ALTEA MEDICAL MONTANA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 E BROADWAY ST
HELENA MT
59601-4990
US

IV. Provider business mailing address

400 E RIVULON BLVD STE 103
GILBERT AZ
85297-0096
US

V. Phone/Fax

Practice location:
  • Phone: 888-408-7008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA KRUEGER
Title or Position: VP OF RCM AND CONTRACTING
Credential:
Phone: 888-408-7008