Organization
DR. VINCENT RIVER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT BRYAN RIVER PHD (PRESIDENT)
(406) 883-8126
Entity
Organization
Contact information
Practice address
1201 MAIN ST, SUITE A, POLSON, MT 59860-5333
(406) 883-8126
(406) 883-9226
Mailing address
1201 MAIN ST, SUITE A, POLSON, MT 59860-5333
(406) 883-8126
(406) 883-9226
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
328
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000051871
BCBS
MT
05
—
490739
—
MT
Enumeration date
08/01/2007
Last updated
11/19/2008
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