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General NPI Number Information
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NPI Number | 1790017226
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Entity Type | Individual
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Provider Name | KEITH A HARBOUR EMT
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Gender | Male
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 29 MILE HIGH LN.
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City | ELLISTON
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State | MT
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Zip | 59728-0196
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Country | US
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Telephone | 406-422-7185
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 196 29 MILE HIGH LN.
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City | ELLISTON
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State | MT
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Zip | 59728-0196
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Country | US
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Telephone | 406-422-7185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 698
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License Number State | MT
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