Individual
TIMOTHY J DEVRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
111 SUNNYVIEW LN, KALISPELL, MT 59901-3164
(406) 752-7900
(406) 257-0253
Mailing address
111 SUNNYVIEW LN, KALISPELL, MT 59901-3164
(406) 752-7900
(406) 257-0253
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
211
MT
363AS0400X
Surgical Physician Assistant
622
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434282
—
MT
Enumeration date
10/28/2005
Last updated
11/27/2023
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