Individual
JACOB WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
445 CENTENNIAL AVE, BUTTE, MT 59701-2870
(406) 723-4075
Mailing address
445 CENTENNIAL AVE, BUTTE, MT 59701-2870
(406) 723-4075
(406) 496-6035
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-157870
MT
Other
Enumeration date
02/13/2020
Last updated
03/28/2022
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