Individual
JASON ENEWOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 1ST AVE N, GREAT FALLS, MT 59401-2510
(406) 454-6973
Mailing address
601 1ST AVE N, GREAT FALLS, MT 59401-2510
(406) 454-6973
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-81142
MT
Other
Enumeration date
01/11/2019
Last updated
05/26/2021
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