Individual
KATHRYN ROSS WALICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3975 US HWY 93 N, STEVENSVILLE, MT 59870-6474
(406) 777-6002
(406) 206-2965
Mailing address
1200 WESTWOOD DR, HAMILTON, MT 59840-2345
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MED-PHYS-LIC-116218
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144783929
—
ID
05
—
200014749
—
MT
Enumeration date
04/09/2019
Last updated
11/12/2024
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