Individual
MR. DOUGLAS M. HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2360 MULLAN RD, SUITE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Mailing address
2360 MULLAN RD, SUITE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
272
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000082090
—
MT
Enumeration date
01/11/2006
Last updated
11/18/2009
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