Individual
ALYCEN R UPDIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 15TH AVE S, GREAT FALLS, MT 59405-4304
(406) 455-2960
Mailing address
2317 4TH AVE S, GREAT FALLS, MT 59405-2950
(406) 771-4807
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
269
MT
Other
Enumeration date
09/29/2008
Last updated
03/11/2010
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