Individual
MRS. DEETTE BALFOURD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPCP
Contact information
Practice address
1821 SOUTH AVE W, 404, MISSOULA, MT 59801-6517
(406) 370-3705
Mailing address
382 STAGECOACH TRL, FLORENCE, MT 59833-6981
(406) 370-3705
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
10049
MT
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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