Individual
ERIC M SCHALLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
107 RIDGEWATER DR, POLSON, MT 59860-8977
(406) 676-4441
(406) 676-0835
Mailing address
107 RIDGEWATER DR, POLSON, MT 59860-8977
(406) 883-3737
(406) 883-2669
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10809
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
903393
BCBS
MT
Enumeration date
06/22/2010
Last updated
10/14/2016
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