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NPI Code Detail

MEDICARE: MR. RODNEY JAMES WALLETTE M.S., C.R.C.

MEDICARE:  MR. RODNEY JAMES WALLETTE  M.S., C.R.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225C00000XRehabilitation Counselor31731 CRCC

General Provider Information

NPI Number : 1386760486
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RODNEY JAMES WALLETTE M.S., C.R.C.
Provider Business Mailing Address
First Line : 595 PATRICK CREEK RD
Second Line :
City : KALISPELL
State : MT
Zip : 59901-7526
Country : US
Telephone Number : 406-755-4883
Fax Number : 406-751-4145
Provider Business Practice Location Address
First Line : 205 SUNNYVIEW LN
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3120
Country : US
Telephone Number : 406-751-4189
Fax Number : 406-751-4527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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