Individual
MARIA ILAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
32 CAMPUS DR, MISSOULA, MT 59812-0004
(406) 243-4521
Mailing address
3520 AMERICAN WAY APT 204, MISSOULA, MT 59808-1788
(425) 985-9454
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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