Provider Demographics
NPI:1932427143
Name:FRONTIER HEALTH CLINIC, PC
Entity Type:Organization
Organization Name:FRONTIER HEALTH CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURELI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCRIBNER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:406-323-4002
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:ROUNDUP
Mailing Address - State:MT
Mailing Address - Zip Code:59072-0646
Mailing Address - Country:US
Mailing Address - Phone:406-323-4002
Mailing Address - Fax:406-323-4022
Practice Address - Street 1:25 1ST AVE W
Practice Address - Street 2:
Practice Address - City:ROUNDUP
Practice Address - State:MT
Practice Address - Zip Code:59072-2831
Practice Address - Country:US
Practice Address - Phone:406-323-4002
Practice Address - Fax:406-323-4022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT24302207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty