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General NPI Number Information
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NPI Number | 1427304047
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Entity Type | Organization
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Legal Business Name | DILLON MEDICAL CLINIC
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 120 S ATLANTIC ST
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City | DILLON
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State | MT
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Zip | 59725-2715
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Country | US
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Telephone | 406-683-4400
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Fax | 406-683-4408
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Provider Business Mailing Address
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Address Line | 120 S ATLANTIC ST
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City | DILLON
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State | MT
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Zip | 59725-2715
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Country | US
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Telephone | 406-683-4400
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Fax | 406-683-4408
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Authorized Official
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Title or Position | OWNER
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Name | TERY HURSH
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Credential | PA-C
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Telephone | 406-683-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 465
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License Number State | MT
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