Provider Demographics
NPI:1083734156
Name:MOWRY, GALE (L AC)
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:
Last Name:MOWRY
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4359
Mailing Address - Country:US
Mailing Address - Phone:406-461-4198
Mailing Address - Fax:
Practice Address - Street 1:25 S EWING ST
Practice Address - Street 2:SUITE 401
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5938
Practice Address - Country:US
Practice Address - Phone:406-461-4198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT163171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist