Individual
TIMOTHY POLACHECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 BERNHARDT RD, LAUREL, MT 59044
(406) 628-1762
Mailing address
101 BERNHARDT RD, LAUREL, MT 59044-8702
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43152
MT
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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