Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | MED-PAC-LIC-100873 | MT |
NPI | 1013687631 |
---|---|
Provider Name | Katie Boyce |
First Address | Billings, MT 59102-6640 |
Second Address | Billings, MT 59102-5564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2021 |
Last Update Date | 30/11/2021 |