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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

Other

Enumeration date
04/17/2023
Last updated
04/17/2023
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