Individual
SHANNON BOESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 BAKER AVE, WHITEFISH, MT 59937-2901
(406) 862-2515
Mailing address
1129 MACKINAW LOOP, SOMERS, MT 59932-9789
(516) 320-5937
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
09/22/2020
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