Provider Demographics
NPI:1881096105
Name:BRIGGEMAN, TOMI (SA-CS)
Entity type:Individual
Prefix:
First Name:TOMI
Middle Name:
Last Name:BRIGGEMAN
Suffix:
Gender:F
Credentials:SA-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MUSKRAT DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5127
Mailing Address - Country:US
Mailing Address - Phone:509-951-0407
Mailing Address - Fax:
Practice Address - Street 1:39 MUSKRAT DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5127
Practice Address - Country:US
Practice Address - Phone:509-951-0407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT102796246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant