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General NPI Number Information
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NPI Number | 1104630557
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Entity Type | Organization
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Legal Business Name | NEXT02 LLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 2831 FORT MISSOULA RD STE 232
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City | MISSOULA
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State | MT
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Zip | 59804-7479
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Country | US
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Telephone | 406-404-8588
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Fax |
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Provider Business Mailing Address
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Address Line | 2831 FORT MISSOULA RD STE 232
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City | MISSOULA
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State | MT
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Zip | 59804-7479
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Country | US
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Telephone | 406-404-8588
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL COLSON
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Credential |
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Telephone | 406-404-8588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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