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Organization
G GREGG NEIBAUER, DPM, INC
Active
Organization
G GREGG NEIBAUER, DPM, INC
Active
Other names
Alpine Foot and Ankle Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GREGG NEIBAUER D.P.M. (PRESIDENT)
(406) 721-4007
Entity
Organization
Contact information
Practice address
1845 BANCROFT ST, MISSOULA, MT 59801-5747
(406) 721-4007
(406) 549-9807
Mailing address
1845 BANCROFT ST, MISSOULA, MT 59801-5747
(406) 721-4007
(406) 549-9807
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
160
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0390779
—
MT
01
—
97315
BLUECROSSBLUESHIELD OF MT
MT
Enumeration date
06/09/2006
Last updated
04/07/2014
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