Healthcare Provider Details

I. General information

NPI: 1659557130
Provider Name (Legal Business Name): MEDICAL WEIGHT MANAGEMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 S EWING ST STE 521
HELENA MT
59601-5753
US

IV. Provider business mailing address

25 S EWING ST STE 521
HELENA MT
59601-5753
US

V. Phone/Fax

Practice location:
  • Phone: 406-442-9302
  • Fax: 406-449-6154
Mailing address:
  • Phone: 406-442-9302
  • Fax: 406-449-6154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number0800008494
License Number StateMT

VIII. Authorized Official

Name: MRS. LINDA L. WINFIELD
Title or Position: PRESIDENT
Credential: NURSE PRACTITIONER
Phone: 406-442-9302