Provider Demographics
NPI:1336387257
Name:WHOLENESS IN HEALTH HOUSE-CALL CLINIC LLC
Entity Type:Organization
Organization Name:WHOLENESS IN HEALTH HOUSE-CALL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGIT
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:GROESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:406-261-5019
Mailing Address - Street 1:37926 MT HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-7746
Mailing Address - Country:US
Mailing Address - Phone:406-261-5019
Mailing Address - Fax:406-883-6465
Practice Address - Street 1:37926 MT HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-7746
Practice Address - Country:US
Practice Address - Phone:406-261-5019
Practice Address - Fax:406-883-6465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21794261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care