Organization
ROSE OSTEOPATHIC CLINIC, INC.
Active
Other names
Defrese Osteopathic Clinic, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DHARMA ROSE D.O. (PRESIDENT)
(406) 745-0845
Entity
Organization
Contact information
Practice address
54699 HILLSIDE RD, ST IGNATIUS, MT 59865-8915
(406) 745-0845
(833) 918-2217
Mailing address
54699 HILLSIDE RD, ST IGNATIUS, MT 59865-8915
(406) 745-0845
(406) 204-3238
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
02001899
IN
261QH0100X
Health Service Clinic/Center
Primary
MED-PHYS-LIC-53457
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518902881
BCBS MONTANA PROVIDER IDENTIFIER
—
05
—
1518902881
—
MT
05
—
200977140A
—
IN
Enumeration date
06/19/2006
Last updated
02/10/2024
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