Individual
MR. GARY ALAN WINGFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 SPEEDWAY AVE, MISSOULA, MT 59802-5566
(406) 549-8127
(406) 542-5202
Mailing address
1300 SPEEDWAY AVE, MISSOULA, MT 59802-5566
(406) 549-8127
(406) 542-5202
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
310400000X
Assisted Living Facility
Primary
10995
MT
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0601477
—
MT
Enumeration date
03/25/2007
Last updated
02/24/2025
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