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General NPI Number Information
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NPI Number | 1184431009
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Entity Type | Organization
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Legal Business Name | TRANQUIL PEAKS WELLNESS AND CONSULTATION
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 3840 MULLAN ROAD APT. 210
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City | MISSOULA
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State | MT
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Zip | 59808
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Country | US
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Telephone | 502-919-2289
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 GRAND AVE STE 129
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City | BILLINGS
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State | MT
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Zip | 59102-2776
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Country | US
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Telephone | 502-919-2289
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA DOSEN
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Credential |
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Telephone | 502-919-2289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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