Healthcare Provider Details

I. General information

NPI: 1902823917
Provider Name (Legal Business Name): HELENA ORTHOPAEDIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2442 WINNE AVE
HELENA MT
59601-4921
US

IV. Provider business mailing address

2442 WINNE AVE
HELENA MT
59601-4915
US

V. Phone/Fax

Practice location:
  • Phone: 406-457-4100
  • Fax: 406-457-4110
Mailing address:
  • Phone: 406-324-9401
  • Fax: 406-457-4110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILIANA DIAZ
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 406-324-9401