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Individual

DIRK GILLETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1287 BURNS WAY, KALISPELL, MT 59901-3109
(406) 752-8120
(406) 752-8134
Mailing address
1287 BURNS WAY, KALISPELL, MT 59901-3109
(406) 752-8120
(406) 752-8134

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
282
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053124
NCCPA
01
1508805920
BCBS
MT
05
1508805920
MT
Enumeration date
06/05/2006
Last updated
11/27/2023
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