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General NPI Number Information
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NPI Number | 1063622496
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Entity Type | Organization
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Legal Business Name | MICHAEL M. MONSON, O.D., P.C.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 1221 DEWEY BLVD
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City | BUTTE
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State | MT
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Zip | 59701-3413
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Country | US
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Telephone | 406-494-2222
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Fax | 406-494-2263
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Provider Business Mailing Address
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Address Line | 1221 DEWEY BLVD
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City | BUTTE
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State | MT
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Zip | 59701-3413
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Country | US
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Telephone | 406-494-2222
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Fax | 406-494-2263
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL MARK MONSON
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Credential | O.D.
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Telephone | 406-494-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 757
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License Number State | MT
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