Individual
JACQUELINE REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W MERCURY ST, BUTTE, MT 59701-1652
(406) 723-1300
(406) 723-1310
Mailing address
300 W MERCURY ST, BUTTE, MT 59701-1652
(406) 723-1300
(406) 723-1310
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
209
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0280618
—
MT
Enumeration date
04/26/2007
Last updated
07/08/2007
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