Individual
NINA SUSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36318 MEMORY LN, POLSON, MT 59860-7265
(406) 883-9221
Mailing address
36248 TURTLE LAKE RD, POLSON, MT 59860-8166
(406) 529-0235
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
20032
NV
183500000X
Pharmacist
Primary
71154
MT
183500000X
Pharmacist
P8935
ID
Other
Enumeration date
10/27/2018
Last updated
11/21/2020
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