MEDICARE: MRS. LISA A FLAMING PT

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
1	174400000X	Specialist	511	MT

General Provider Information

NPI Number	:	1639235740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA A FLAMING PT

Provider Business Mailing Address
First Line	:	2318 VIRGINIA LN
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-2505
Country	:	US
Telephone Number	:	406-252-0717
Fax Number	:

Provider Business Practice Location Address
First Line	:	2318 VIRGINIA LN
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-2505
Country	:	US
Telephone Number	:	406-252-0717
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2006
Last Update Date	:	07/08/2007

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