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General NPI Number Information
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NPI Number | 1477638732
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Entity Type | Organization
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Legal Business Name | ELKHORN MOUNTAIN CYTOLOGY LLC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 01/15/2010
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Provider Practice Location Address
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Address Line | 21 N LAST CHANCE GULCH ST STE 205
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City | HELENA
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State | MT
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Zip | 59601-4199
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Country | US
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Telephone | 406-442-5001
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Fax | 406-442-4438
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Provider Business Mailing Address
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Address Line | 21 N LAST CHANCE GULCH ST STE 205
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City | HELENA
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State | MT
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Zip | 59601-4199
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Country | US
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Telephone | 406-442-5001
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Fax | 406-442-4438
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DENNIS JOSEPH HELLMAN
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Credential |
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Telephone | 406-442-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 27D0966466
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License Number State | MT
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