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NPI 1073785572

NPI 1073785572 : WOMENS HEALTH LLC : MISSOULA, MT

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General NPI Number Information
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    NPI Number           |    1073785572
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    Entity Type          |    Organization 
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    Legal Business Name  |    WOMENS HEALTH LLC 
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Dates
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    Enumeration Date     |    03/25/2008
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    Last Update Date     |    04/20/2008
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Provider Practice Location Address
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    Address Line         |    2825 FORT MISSOULA RD 115
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    City                 |    MISSOULA
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    State                |    MT
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    Zip                  |    59804-7420
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    Country              |    US
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    Telephone            |    406-728-4292
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    Fax                  |    406-728-5770
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Provider Business Mailing Address
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    Address Line         |    2825 FORT MISSOULA RD 115
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    City                 |    MISSOULA
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    State                |    MT
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    Zip                  |    59804-7420
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    Country              |    US
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    Telephone            |    406-728-4292
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    Fax                  |    406-728-5770
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. GARY PHILLIP HARVEY 
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    Credential           |    MD
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    Telephone            |    406-728-4292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207VG0400X
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    Taxonomy Name        |    Gynecology Physician
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    License Number       |    7259
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    License Number State |    MT
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