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General NPI Number Information
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NPI Number | 1588250120
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Entity Type | Organization
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Legal Business Name | RIVER CITY HEALTH INC
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Dates
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Enumeration Date | 12/17/2020
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Last Update Date | 12/17/2020
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Provider Practice Location Address
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Address Line | 1101 S 3RD ST W STE 101
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City | MISSOULA
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State | MT
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Zip | 59801-2321
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Country | US
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Telephone | 406-214-2040
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Fax | 888-700-9240
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Provider Business Mailing Address
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Address Line | 1101 S 3RD ST W STE 101
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City | MISSOULA
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State | MT
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Zip | 59801-2321
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Country | US
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Telephone | 406-214-2040
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Fax | 888-700-9240
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA LYNN LEISHMAN
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Credential |
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Telephone | 406-529-5673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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