Healthcare Provider Details

I. General information

NPI: 1356032155
Provider Name (Legal Business Name): MONTANA ADVANCED PAIN AND SPINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 S 22ND AVE STE 100
BOZEMAN MT
59718-7070
US

IV. Provider business mailing address

1819 S 22ND AVE STE 100
BOZEMAN MT
59718-7070
US

V. Phone/Fax

Practice location:
  • Phone: 406-426-3200
  • Fax: 406-920-7246
Mailing address:
  • Phone: 406-426-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY STRIGENZ
Title or Position: OWNER/ADMINISTRATOR
Credential: MD
Phone: 503-449-7923