Healthcare Provider Details

I. General information

NPI: 1659663425
Provider Name (Legal Business Name): TREASURE STATE HEARING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 STONERIDGE DR UNIT 1
BOZEMAN MT
59718
US

IV. Provider business mailing address

1122 STONERIDGE DR UNIT 1
BOZEMAN MT
59718
US

V. Phone/Fax

Practice location:
  • Phone: 406-551-2244
  • Fax: 406-551-2245
Mailing address:
  • Phone: 406-551-2244
  • Fax: 406-551-2245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number1284
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MR. NATHAN JAMES PUTNAM
Title or Position: OWNER/AUDIOLOGIST
Credential: M.S. CCC-A
Phone: 406-551-2244