Individual
LAUREL HELENE DESNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 RIVER DR, LIVINGSTON, MT 59047-3716
(406) 222-0800
(406) 222-7606
Mailing address
504 S 13TH ST, LIVINGSTON, MT 59047-3727
(406) 823-6414
(406) 823-6287
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
620316
MT
207R00000X
Internal Medicine Physician
MD00036360
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4575
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8247553
—
WA
Enumeration date
10/27/2006
Last updated
03/11/2014
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