Individual
TERASA LOUISE PROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
310 SUNNYVIEW LN, KALISPELL, MT 59901-3129
(406) 751-6725
(406) 758-5170
Mailing address
310 SUNNYVIEW LN, KALISPELL, MT 59901-3129
(406) 751-6725
(406) 758-5170
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
DR55865
CO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MED-PHYS-LIC-99776
MT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
MED-PHYS-LIC-99776
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311325
IM
CO
Enumeration date
04/26/2007
Last updated
08/10/2021
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