MEDICARE: KJETIL DANIEL COLLETT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1811789936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KJETIL DANIEL COLLETT DO

Provider Business Mailing Address
First Line	:	2901 SHADOW OAKS PL
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-0777
Country	:	US
Telephone Number	:	406-698-8587
Fax Number	:

Provider Business Practice Location Address
First Line	:	4130 ROCKY VISTA WAY
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59106-2961
Country	:	US
Telephone Number	:	406-901-2700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2025
Last Update Date	:	05/22/2025

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