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General NPI Number Information
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NPI Number | 1093759748
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Entity Type | Organization
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Legal Business Name | MONTANA FOOT CLINIC PC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 3419 CENTRAL AVE STE B
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City | BILLINGS
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State | MT
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Zip | 59102-6647
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Country | US
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Telephone | 406-245-0888
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Fax | 406-245-1322
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Provider Business Mailing Address
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Address Line | 3419 CENTRAL AVE STE B
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City | BILLINGS
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State | MT
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Zip | 59102-6647
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Country | US
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Telephone | 406-245-0888
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Fax | 406-245-1322
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Authorized Official
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Title or Position | OWNER
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Name | MATHIAS H FETTIG
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Credential | DPM
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Telephone | 406-245-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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