Provider Information for 1639697105
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JENNA PLOUFFE
Sex: Female
NPI: 1639697105
Last Updated: 2017-09-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1639697105 | ||||||||
| Enumeration Date | 2017-09-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 805 N WASHINGTON ST APT 2 HELENA, MT 59601-3264 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 3240 DREDGE DR HELENA, MT 59602-0548 United States Phone: 406-442-9207 | Fax: | ||||||||
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