Healthcare Provider Details

I. General information

NPI: 1205386190
Provider Name (Legal Business Name): PEAK HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

862 HARMON STREAM BLVD SUITE 101
BOZEMAN MT
59718-4091
US

IV. Provider business mailing address

862 HARMON STREAM BLVD SUITE 101
BOZEMAN MT
59718-4091
US

V. Phone/Fax

Practice location:
  • Phone: 406-548-8719
  • Fax: 406-388-8710
Mailing address:
  • Phone: 406-548-8719
  • Fax: 406-388-8710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID STERN
Title or Position: OWNER/MD
Credential: MD
Phone: 406-548-8719