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BLACK BEAR NATUROPATHIC CLINIC, PC

Suppliers Non-Pharmacy Dispensing Site

Provider NPI: 1033466966

Organization Information:
Organization Name:  BLACK BEAR NATUROPATHIC CLINIC, PC
Organization is Subpart
Authorized Official:  CHRISTINE C. WHITE  OWNER  406-542-2147

Practice Location:
2204 DIXON AVE  MISSOULA, MT 59801-8224 US
Tel: 406-542-2147  Fax: --

Business Mailing Address:
2980 N BEVERLY GLEN CIR SUITE 301 LOS ANGELES, CA 90077-1726 US
Tel: 310-474-9809  Fax: --

NPI Information:
NPI: 1033466966
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y332900000XSuppliers
Non-Pharmacy Dispensing Site

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 332900000X

Type:

Classification:



Definition:



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