Organization
THOMAS J. CLUCAS, PHD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS J. CLUCAS PHD (DIRECTOR)
(406) 549-7325
Entity
Organization
Contact information
Practice address
125 BANK ST STE 310, MISSOULA, MT 59802-4413
(406) 549-7325
Mailing address
125 BANK ST STE 310, MISSOULA, MT 59802-4413
(406) 549-7325
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
186
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083763643
—
MT
01
—
51981
BLUE CROSS BLUE SHIELD
MT
Enumeration date
03/11/2008
Last updated
04/10/2008
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