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Organization
ORIGIN HEALTH LLC
Active
Organization
ORIGIN HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN G LOOSLI MSC (EXECUTIVE DIRECTOR)
(208) 557-9898
Entity
Organization
Contact information
Practice address
2831 FORT MISSOULA RD STE 232, MISSOULA, MT 59804-7479
(406) 523-5650
(406) 303-4041
Mailing address
2831 FORT MISSOULA RD STE 232, MISSOULA, MT 59804-7479
(406) 523-5650
(406) 303-4041
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
—
—
207VG0400X
Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
207VX0000X
Obstetrics Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
2471S1302X
Sonography Radiologic Technologist
—
—
Other
Enumeration date
11/11/2019
Last updated
06/23/2020
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