Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 50865 | MN |
NPI | 1265691083 |
---|---|
Provider Name | Dr. Janna J Vilen |
First Address | Helena, MT 59602-7804 |
Second Address | Helena, MT 59602-7804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 10/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80268 | MONTANA LICENSE (01) | MT |