Organization
ROSE OSTEOPATHIC CLINIC, INC.
Active
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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