Healthcare Provider Details
I. General information
NPI: 1104857028
Provider Name (Legal Business Name): ARNT JAMES OFSTAD, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
417 MAIN ST SW
RONAN MT
59864-2738
US
IV. Provider business mailing address
417 MAIN ST SW
RONAN MT
59864-2738
US
V. Phone/Fax
- Phone: 406-676-8921
- Fax: 406-676-3938
- Phone: 406-676-8921
- Fax: 406-676-3938
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 381OPT |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 381OPT |
| License Number State | MT |
VIII. Authorized Official
Name:
ARNT
JAMES
OFSTAD
Title or Position: OWNER/DOCTOR
Credential: O.D.
Phone: 406-676-8921