Healthcare Provider Details

I. General information

NPI: 1013833581
Provider Name (Legal Business Name): HAUTE ROUTE SPORTS MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 W MAIN ST APT 522
BOZEMAN MT
59715-4779
US

IV. Provider business mailing address

421 W MAIN ST APT 522
BOZEMAN MT
59715-4779
US

V. Phone/Fax

Practice location:
  • Phone: 303-332-5047
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTIAN DEAN
Title or Position: PHYSICIAN
Credential: DO
Phone: 303-332-5047