Healthcare Provider Details

I. General information

NPI: 1063639029
Provider Name (Legal Business Name): MARIA LYN HUNTLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 01/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 E BROADWAY SUITE 204
HELENA MT
59601
US

IV. Provider business mailing address

2525 E BROADWAY SUITE 204
HELENA MT
59601
US

V. Phone/Fax

Practice location:
  • Phone: 406-457-4366
  • Fax: 406-457-4367
Mailing address:
  • Phone: 406-457-4366
  • Fax: 406-457-4367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA L HUNTLEY
Title or Position: OWNER
Credential: M.D.
Phone: 406-457-4366