Organization
MOUNTAIN COUNTRY WOMEN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN MARIE WICKLUND MD (PRESIDENT)
(406) 222-7555
Entity
Organization
Contact information
Practice address
207 S MAIN ST, LIVINGSTON, MT 59047-3016
(406) 222-7555
Mailing address
PO BOX 1780, LIVINGSTON, MT 59047-4702
(406) 222-7555
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
7268
MT
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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