Organization
MOMENTUM PROSTHETIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFFORD HENRY CREEKMORE CPO (PRACTITIONER/MANAGING MEMBER)
(406) 529-0474
Entity
Organization
Contact information
Practice address
3817 STEPHENS AVE STE 2, MISSOULA, MT 59801-8542
(406) 926-1321
(406) 926-1327
Mailing address
3817 STEPHENS AVE STE 2, MISSOULA, MT 59801-8505
(406) 926-1321
(406) 926-1327
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
2015-MSS-GEN-00092
MT
Other
Enumeration date
04/13/2015
Last updated
03/02/2022
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