Individual
MS. TANA LYNN MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM-D
Contact information
Practice address
1615 S 11TH ST W, MISSOULA, MT 59801
(406) 546-9557
Mailing address
1615 S 11TH ST W, MISSOULA, MT 59801-4837
(406) 546-9557
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5214
MT
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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