Healthcare Provider Details

I. General information

NPI: 1346421161
Provider Name (Legal Business Name): DR JODY L FINK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 W MADISON AVE SUITE B
BELGRADE MT
59714-3915
US

IV. Provider business mailing address

91 W MADISON AVE SUITE B
BELGRADE MT
59714-3915
US

V. Phone/Fax

Practice location:
  • Phone: 406-388-2488
  • Fax:
Mailing address:
  • Phone: 406-388-2488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number776
License Number StateMT

VIII. Authorized Official

Name: DR. JODY LYNN FINK
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 406-587-0668