Healthcare Provider Details

I. General information

NPI: 1730208844
Provider Name (Legal Business Name): CENTER FOR JOINT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N ORANGE ST STE 103
MISSOULA MT
59802-2951
US

IV. Provider business mailing address

900 N ORANGE ST STE 103
MISSOULA MT
59802-2951
US

V. Phone/Fax

Practice location:
  • Phone: 406-728-1563
  • Fax: 406-542-1037
Mailing address:
  • Phone: 406-728-1563
  • Fax: 406-542-1037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number492
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN18519
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number4807
License Number StateMT
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number10146
License Number StateMT

VIII. Authorized Official

Name: DR. DAVID H ALLMACHER
Title or Position: OWNER
Credential: MD
Phone: 406-728-1563