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Individual

MRS. DONNA MARY ALINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2442 WINNE AVE, HELENA, MT 59601-4915
(406) 449-7887
(406) 449-7888
Mailing address
29 PINE RIDGE CIR, CLANCY, MT 59634-9760
(406) 933-5969

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
130
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000061230
BLUE CROSS
MT
05
0341496
MT
01
168678
WAWC
MT
01
650019573
RR MEDICARE
MT
01
841391220003
EBMS
MT
01
MSF0520433
MT STATE FUND
MT
Enumeration date
01/25/2006
Last updated
10/12/2011
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