Healthcare Provider Details

I. General information

NPI: 1083015358
Provider Name (Legal Business Name): CENTRAL MONTANA EYECARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2014
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 14TH ST SW
GREAT FALLS MT
59404-3486
US

IV. Provider business mailing address

2012 14TH ST SW
GREAT FALLS MT
59404-3486
US

V. Phone/Fax

Practice location:
  • Phone: 406-453-1900
  • Fax: 406-453-1700
Mailing address:
  • Phone: 406-453-1900
  • Fax: 406-453-1700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MORGAN R LEACH
Title or Position: OWNER/OPERATOR
Credential: OD
Phone: 406-453-1900