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Organization
LIVINGSTON MED SPA PLLC
Active
Organization
LIVINGSTON MED SPA PLLC
Active
Other names
LIV MED SPA
Organization subpart
No
Provider details
NPI number
Authorized official
GRETCHEN WISE NP (OWNER)
(406) 224-3036
Entity
Organization
Contact information
Practice address
115 HIGH GROUND AVE, LIVINGSTON, MT 59047-3906
(406) 224-3036
Mailing address
115 HIGH GROUND AVE, LIVINGSTON, MT 59047-3906
(406) 224-3036
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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