Individual
CODY WAYNE BOHLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
1009 BRIARWOOD CT, GREAT FALLS, MT 59405
(406) 781-5579
Mailing address
1009 BRIARWOOD CT, GREAT FALLS, MT 59405
(406) 781-5579
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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