Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 18608 | MT |
NPI | 1003090481 |
---|---|
Provider Name | Dr. Melissa Rae Reily |
First Address | Bozeman, MT 59715-6902 |
Second Address | Bozeman, MT 59715-6907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2007 |
Last Update Date | 26/07/2021 |