Individual
PAUL TIEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3425 SGT SANDERS ST, MISSOULA, MT 59804-7224
(406) 450-2264
Mailing address
780 TOX DR, MISSOULA, MT 59804-1932
(406) 450-2264
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
78911
MT
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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