Provider Demographics
NPI:1225195514
Name:COUNTY OF TETON
Entity type:Organization
Organization Name:COUNTY OF TETON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER NURSEPUBLIC HEALTH NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-466-2562
Mailing Address - Street 1:905 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CHOTEAU
Mailing Address - State:MT
Mailing Address - Zip Code:59422-9123
Mailing Address - Country:US
Mailing Address - Phone:406-466-2562
Mailing Address - Fax:406-466-5292
Practice Address - Street 1:905 4TH ST NW
Practice Address - Street 2:
Practice Address - City:CHOTEAU
Practice Address - State:MT
Practice Address - Zip Code:59422-9123
Practice Address - Country:US
Practice Address - Phone:406-466-2562
Practice Address - Fax:406-466-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT03126-8OtherBCBS CHIP
MT3503682Medicaid
MT3503682Medicaid