Organization
MONTANA FOOT AND ANKLE INSTITUTE, PLLC
Active
Other names
Missoula Foot and Ankle Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARL JOSEPH MANGOLD D.P.M. (OWNER/MANAGER)
(406) 552-5050
Entity
Organization
Contact information
Practice address
2825 FORT MISSOULA RD, SUITE #106, MISSOULA, MT 59804-7420
(406) 543-5333
(406) 543-5621
Mailing address
2825 FORT MISSOULA RD, SUITE #106, MISSOULA, MT 59804-7420
(406) 543-5333
(406) 543-5621
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
174
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M011000091
MEDICARE PTAN
MT
Enumeration date
12/13/2010
Last updated
05/23/2011
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