Individual
MATTHEW HERTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3687 VETERANS DR, FORT HARRISON, MT 59636-9703
(406) 447-7194
Mailing address
1200 N WASHINGTON ST, HELENA, MT 59601-3238
(406) 442-4706
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
39675
MT
164W00000X
Licensed Practical Nurse
L1495260
MI
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
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