Individual
KENNY JOE WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.N.P.
Contact information
Practice address
600 STATE HWY 91 S, DILLON, MT 59725-7379
(406) 683-3000
Mailing address
386 WHITE HORSE LOOP, BOZEMAN, MT 59718-1223
(918) 906-1697
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
132231
MT
367500000X
Certified Registered Nurse Anesthetist
Primary
132231
MT
Other
Enumeration date
06/01/2016
Last updated
12/08/2025
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