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General NPI Number Information
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NPI Number | 1235820739
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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 | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 2405 BROOKS ST
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City | MISSOULA
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State | MT
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Zip | 59801-7869
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Country | US
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Telephone | 406-493-0433
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Fax |
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Provider Business Mailing Address
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Address Line | 1648 ELLIS ST STE 102
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City | BOZEMAN
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State | MT
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Zip | 59715-8811
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Country | US
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Telephone | 406-585-1440
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Fax |
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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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