# THE LAUREL CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE LAUREL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710168596
- **Authorized official:** DR. ROBERT BRUCE VANNICE M.D. (OWNER)
- **Authorized official phone:** (406) 628-4955

## Contact information

- **Practice address:** 319 1ST AVE, LAUREL, MT 59044-3031
- **Practice address phone:** (406) 628-4955
- **Practice address fax:** (406) 628-4362
- **Mailing address:** PO BOX 445, LAUREL, MT 59044-0445
- **Mailing address phone:** (406) 628-4955
- **Mailing address fax:** (406) 628-4362

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/20/2007
- **Last updated:** 11/20/2007