Provider Demographics
NPI:1174760649
Name:WILHELM, HORST ANTON (LAC)
Entity type:Individual
Prefix:
First Name:HORST
Middle Name:ANTON
Last Name:WILHELM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1627
Mailing Address - Street 2:
Mailing Address - City:RED LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59068-1627
Mailing Address - Country:US
Mailing Address - Phone:406-780-1387
Mailing Address - Fax:
Practice Address - Street 1:9340 S FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-6100
Practice Address - Country:US
Practice Address - Phone:406-780-1387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT187171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist