Healthcare Provider Details

I. General information

NPI: 1932427143
Provider Name (Legal Business Name): FRONTIER HEALTH CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 1ST AVE W
ROUNDUP MT
59072-2831
US

IV. Provider business mailing address

PO BOX 646
ROUNDUP MT
59072-0646
US

V. Phone/Fax

Practice location:
  • Phone: 406-323-4002
  • Fax: 406-323-4022
Mailing address:
  • Phone: 406-323-4002
  • Fax: 406-323-4022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24302
License Number StateMT

VIII. Authorized Official

Name: MS. LAURELI SCRIBNER
Title or Position: DIRECTOR
Credential: FNP
Phone: 406-323-4002