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General NPI Number Information
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NPI Number | 1083264816
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Entity Type | Organization
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Legal Business Name | MONTANA STATE UNIVERSITY - BILLINGS
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 1500 UNIVERSITY DR
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City | BILLINGS
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State | MT
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Zip | 59101-0245
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Country | US
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Telephone | 406-657-2369
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 SPRING VALLEY RD
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City | DALLAS
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State | TX
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Zip | 75244-3995
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KRISTA LEA MONTAGUE
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Credential |
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Telephone | 406-657-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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