Individual
MARISA RENEE LLAMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2740 SOUTH AVE W STE 101, MISSOULA, MT 59804-5137
(406) 728-6101
Mailing address
60386 E LOOSE REINS PL, TUCSON, AZ 85739-5903
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-144583-
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/08/2023
Last updated
12/06/2024
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