Individual
MATTHEW CLAYTON TAECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 38TH AVE NE, GREAT FALLS, MT 59404
(605) 680-9383
Mailing address
113 38TH AVE NE, GREAT FALLS, MT 59404
(605) 680-9383
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
33941
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2010
Last updated
04/05/2024
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