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General NPI Number Information
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NPI Number | 1477218188
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Entity Type | Organization
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Legal Business Name | GALLATIN VALLEY VISION, LLC
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 9 E BIRCH ST
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City | THREE FORKS
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State | MT
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Zip | 59752
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Country | US
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Telephone | 406-285-6901
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Fax | 406-285-6511
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Provider Business Mailing Address
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Address Line | PO BOX 1008
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City | THREE FORKS
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State | MT
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Zip | 59752-1008
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Country | US
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Telephone | 406-285-6901
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | JESSICA N LEMONS
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Credential | OD
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Telephone | 406-285-6901
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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 |
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License Number State |
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