Individual
KIM BIG KNIFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC-E
Contact information
Practice address
96 CLINIC RD N, BOX ELDER, MT 59521-8849
(406) 395-4818
(406) 395-4861
Mailing address
96 CLINIC RD N, BOX ELDER, MT 59521-8849
(406) 395-4818
(406) 395-4861
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
BBH-ACLA-LIC-18786
MT
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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