Individual
RENITA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EMT
Contact information
Practice address
535 CLINIC RD E, BOX ELDER, MT 59521-8826
(406) 395-4374
Mailing address
535 CLINIC RD E, BOX ELDER, MT 59521-8826
(406) 395-4374
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
1120
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1120
MONTANA STATE LICENSED EMT
MT
Enumeration date
12/03/2013
Last updated
12/03/2013
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