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General NPI Number Information
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NPI Number | 1831020825
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Entity Type | Organization
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Legal Business Name | COURTNEY L FUNDERBURK
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 05/27/2026
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Provider Practice Location Address
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Address Line | 510 5TH AVE STE B
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City | HAVRE
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State | MT
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Zip | 59501-4015
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Country | US
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Telephone | 406-201-5193
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Fax | 406-403-0281
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Provider Business Mailing Address
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Address Line | 84 20TH ST
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City | HAVRE
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State | MT
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Zip | 59501-5260
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Country | US
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Telephone | 406-201-5193
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Fax | 406-201-5193
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Authorized Official
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Title or Position | OWNER/OPERATOR/PROVIDER
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Name | COURTNEY FUNDERBURK
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Credential |
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Telephone | 406-201-5193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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