Bozeman Sports Medicine, INC.
Family Medicine, Sports Medicine in Bozeman, MT. Organization (NPI-2).
NPI number1164083531
StatusActive
Last updated in NPPESSep 28, 2021
Details
- NPI
- 1164083531
- Entity type
- Organization (NPI-2)
- Legal business name
- Bozeman Sports Medicine, INC.
- Organization subpart
- No
- Enumeration date
- Jun 25, 2019
- Certification date
- Sep 28, 2021
- Last updated
- Sep 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QS0010X | Family Medicine, Sports Medicine | – | – | Yes |
Practice location
4181 Fallon St Ste 2Bozeman, MT 59718-4400
Phone 406-586-2865 · Fax 406-558-2891
Mailing address
117 E Oak St Ste 1aBozeman, MT 59715-2977
Phone 406-595-3861 · Fax 406-586-9708
Authorized official
Erik Stuart Adams
President
4065953861
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