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General NPI Number Information
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NPI Number | 1497938484
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Entity Type | Organization
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Legal Business Name | WOODLAND CLINIC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/21/2007
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Provider Practice Location Address
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Address Line | 705 6TH AVE E
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City | KALISPELL
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State | MT
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Zip | 59901-5008
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Country | US
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Telephone | 406-755-7366
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Fax | 406-755-7277
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Provider Business Mailing Address
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Address Line | 610 7TH ST E
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City | KALISPELL
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State | MT
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Zip | 59901-5047
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Country | US
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Telephone | 406-755-7366
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Fax | 406-755-7277
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JULIE VANEK
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Credential |
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Telephone | 406-755-7366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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