Individual
BRENDA ROSE ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1809 15TH AVE S, GREAT FALLS, MT 59405-4820
(406) 315-3111
Mailing address
PO BOX 6724, GREAT FALLS, MT 59406-6724
(406) 315-3111
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
340889IC
MT
Other
Enumeration date
05/05/2017
Last updated
05/05/2017
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