Healthcare Provider Details

I. General information

NPI: 1912308578
Provider Name (Legal Business Name): WYSCRIPTZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 S RESERVE ST STE 109
MISSOULA MT
59801-6451
US

IV. Provider business mailing address

2120 S RESERVE ST STE 109
MISSOULA MT
59801-6451
US

V. Phone/Fax

Practice location:
  • Phone: 406-493-7782
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHAD HANDLEY
Title or Position: OPERATING MANAGER
Credential:
Phone: 406-493-7782