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Individual

MS. PAMELA JUNE RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
101 RICKETTS RD, HAMILTON, MT 59840-9320
(406) 381-5805
Mailing address
101 RICKETTS RD, HAMILTON, MT 59840-9320
(406) 381-5805

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
MT
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0035030-001
MT

Other

Enumeration date
07/28/2008
Last updated
07/09/2024
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