Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 791 | MT |
NPI | 1588695662 |
---|---|
Provider Name | Dr. Ray H Garth II |
First Address | Whitefish, MT 59937-8265 |
Second Address | Whitefish, MT 59937-8265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |