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General NPI Number Information
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NPI Number | 1205192440
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Entity Type | Organization
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Legal Business Name | FUGLEBERG ENTERPRISES INC
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 12/31/2012
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Provider Practice Location Address
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Address Line | 2831 FORT MISSOULA RD SUITE 300
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City | MISSOULA
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State | MT
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Zip | 59804-7419
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Country | US
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Telephone | 406-542-5200
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Fax | 406-542-1951
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Provider Business Mailing Address
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Address Line | 2831 FORT MISSOULA RD SUITE 300
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City | MISSOULA
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State | MT
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Zip | 59804-7419
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Country | US
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Telephone | 406-542-5200
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Fax | 406-542-1951
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Authorized Official
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Title or Position | PRESIDENT
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Name | RUTH FUGLEBERG HINTHER
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Credential | MCSD, CCC-A
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Telephone | 406-542-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 676
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License Number State | MT
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