Most Relevant Information
Provider Data
| NPI Number: | 1003379868 |
| Provider Name: | BRIE PROCTOR DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/09/2019 |
| Last Updated: | 02/19/2024 |
Provider Practice Location
160 HERITAGE WAY STE 202
KALISPELL
MT
599013127
Practice Location Phone/Fax
| Phone: | 4067528433 |
| Fax: | 4067566768 |
Provider Mailing Location
14075 W KILLABREW RD
HULBERT
OK
744413717
Provider Mailing Phone/Fax
| Phone: | 4055351728 |
| Fax: |