Organization
KIM SALLOUX LAC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM GRETHER SALLOUX LAC (OWNER)
(415) 845-7288
Entity
Organization
Contact information
Practice address
109 W CALLENDER SUITE 2E, LIVINGSTON, MT 59047
(415) 846-7288
Mailing address
214 S 7TH, LIVINGSTON, MT 59047
(415) 846-7288
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
32222
MT
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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