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Organization
CHRONIC DISEASE MANAGEMENT, LLC
Active
Organization
CHRONIC DISEASE MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DONALD KISHBAUGH PA-C (MANAGER)
(406) 224-2244
Entity
Organization
Contact information
Practice address
7 MICROWAVE HILL RD STE C, CLANCY, MT 59634-8001
(406) 946-2983
Mailing address
PO BOX 44, BOULDER, MT 59632-0044
(406) 224-2244
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
NULL
363A00000X
Physician Assistant
Primary
—
NULL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
07/27/2023
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