Individual
MS. JAIME ALEXIS STATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
1900 S RESERVE ST, MISSOULA, MT 59801-6455
(406) 721-9080
(406) 721-9008
Mailing address
1900 S RESERVE ST, MISSOULA, MT 59801-6455
(406) 721-9080
(406) 721-9008
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
MT
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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