Organization
MALTA FAMILY HEALTH CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAD E GIBLETTE FNP (OWNER)
(406) 654-2000
Entity
Organization
Contact information
Practice address
830 1/2 CENTRAL AVE, MALTA, MT 59538
(406) 654-2000
(406) 654-2135
Mailing address
PO BOX 39, MALTA, MT 59538-0039
(406) 654-2000
(406) 654-2135
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
25089
MT
Other
Enumeration date
04/23/2012
Last updated
04/23/2012
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