Individual
MANUEL A PROENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1101 26TH ST S, GREAT FALLS, MT 59405-5161
(406) 731-8888
(406) 731-8318
Mailing address
PO BOX 6010, GREAT FALLS, MT 59406-6010
(406) 731-8888
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
142414
MT
208000000X
Pediatrics Physician
DO1964
NV
Other
Enumeration date
06/15/2012
Last updated
06/27/2024
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