Organization · NPI-2

Bozeman Clinic Pllp

Family Medicine · Bozeman, MT

NPI number1013936244
StatusActive
Last updated in NPPESJan 4, 2019

Details

NPI
1013936244
Entity type
Organization (NPI-2)
Legal business name
Bozeman Clinic Pllp
Organization subpart
No
Enumeration date
Jul 19, 2006
Last updated
Jan 4, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

931 Highland Blvd
Suite 3360
Bozeman, MT 59715

Phone 406-587-4242 · Fax 406-587-3507

Mailing address

931 Highland Blvd
Suite 3360
Bozeman, MT 59715

Phone 406-587-4242 · Fax 406-587-3507

Authorized official

Judith J. Douglas
Administrator
4065874242

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