Organization
GLACIER PROSTHETIC CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA CARPENTER (VICE PRESIDENT)
(406) 755-3344
Entity
Organization
Contact information
Practice address
1110 W PARK PL, SUITE 202, COEUR D ALENE, ID 83814-2781
(208) 667-3344
(208) 667-2745
Mailing address
985 N MERIDIAN RD, KALISPELL, MT 59901-3539
(406) 755-3344
(406) 755-2746
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/04/2010
Last updated
09/15/2010
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