Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 130 | MT |
NPI | 1255376844 |
---|---|
Provider Name | Mary A Borgrud-Krenik |
First Address | Billings, MT 59107-5100 |
Second Address | Billings, MT 59101-0905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 02/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000050610 | (05) | MT |