Healthcare Provider Details

I. General information

NPI: 1861008443
Provider Name (Legal Business Name): JUSTYNA WOJTYCZKA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 S COTTONWOOD RD STE 100
BOZEMAN MT
59718-9529
US

IV. Provider business mailing address

536 S COTTONWOOD RD STE 100
BOZEMAN MT
59718-9529
US

V. Phone/Fax

Practice location:
  • Phone: 406-586-8029
  • Fax: 406-586-8009
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: