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General NPI Number Information
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NPI Number | 1134145139
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Entity Type | Organization
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Legal Business Name | TREASURE STATE ORTHOTIC &PROSTHETIC CLINIC, INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 1648 ELLIS ST SUITE 102
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City | BOZEMAN
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State | MT
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Zip | 59715-8810
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Country | US
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Telephone | 406-585-1440
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Fax | 406-585-1438
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Provider Business Mailing Address
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Address Line | 1648 ELLIS ST SUITE 102
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City | BOZEMAN
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State | MT
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Zip | 59715-8810
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Country | US
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Telephone | 406-585-1440
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Fax | 406-585-1438
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Authorized Official
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Title or Position | HR/AP DIRECTOR
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Name | MARGARET MURFITT
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Credential |
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Telephone | 406-585-1440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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