Individual
SHAYNA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
304 NORTH 2ND STREET, TROY, MT 59935
(406) 295-4044
Mailing address
PO BOX 1068, TROY, MT 59935-1068
(406) 295-4044
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
LMT-LMTLIC2633
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
371665384
INS.
—
Enumeration date
07/24/2015
Last updated
07/24/2015
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