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General NPI Number Information
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NPI Number | 1073142717
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Entity Type | Organization
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Legal Business Name | TOMMIE L PERUSICH, PC
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Dates
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Enumeration Date | 04/04/2020
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 84 OHIO ST STE 5
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City | BUTTE
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State | MT
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Zip | 59701-1806
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Country | US
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Telephone | 406-646-2470
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Fax | 406-299-3911
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Provider Business Mailing Address
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Address Line | 84 OHIO ST STE 5
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City | BUTTE
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State | MT
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Zip | 59701-1806
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Country | US
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Telephone | 406-646-2470
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Fax | 406-299-3911
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Authorized Official
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Title or Position | GENERAL MANAGER / BILLING
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Name | MR. DARREN A HOFFMAN
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Credential |
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Telephone | 406-646-2470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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