Healthcare Provider Details

I. General information

NPI: 1093239139
Provider Name (Legal Business Name): ALEPH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 07/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 W MAIN ST
BOZEMAN MT
59715-6821
US

IV. Provider business mailing address

2120 SOUTH RESERVE PMB 117
MISSOULA MT
59801
US

V. Phone/Fax

Practice location:
  • Phone: 406-541-4673
  • Fax: 406-728-5358
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRYAN CHALMERS
Title or Position: COO
Credential:
Phone: 406-541-4673