Individual
CASEY KICKINGWOMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1333 TOOLE AVE UNIT 32, MISSOULA, MT 59802-2349
(406) 381-1267
Mailing address
1333 TOOLE AVE UNIT 32, MISSOULA, MT 59802-2349
(406) 381-1267
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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