Individual
JANEL D MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 721-5600
(406) 327-3065
Mailing address
PO BOX 7638, MISSOULA, MT 59807-7638
(406) 721-5600
(406) 721-5600
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
315
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4300270
—
MT
Enumeration date
06/24/2006
Last updated
01/12/2016
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