Healthcare Provider Details

I. General information

NPI: 1295313096
Provider Name (Legal Business Name): RACHEL BORNTRAGER NBCHWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 W 1ST AVE
PLENTYWOOD MT
59254-1504
US

IV. Provider business mailing address

26 9 MILE RD
RAYMOND MT
59256-7500
US

V. Phone/Fax

Practice location:
  • Phone: 406-765-7259
  • Fax:
Mailing address:
  • Phone: 406-765-7259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: