Individual
MRS. NEVADA BENNETT THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2622 W MAIN ST, SUITE D, BOZEMAN, MT 59718-3967
(406) 587-9679
Mailing address
2622 W MAIN ST, SUITE D, BOZEMAN, MT 59718-3967
(406) 587-9679
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
LMT-LMT-LIC-908
MT
Other
Enumeration date
10/11/2013
Last updated
10/11/2013
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