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General NPI Number Information
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NPI Number | 1639091671
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Entity Type | Organization
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Legal Business Name | MOOSE MEDICAL MANAGEMENT OF MONTANA LLC
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 3572 HESPER RD
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City | BILLINGS
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State | MT
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Zip | 59102-6891
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Country | US
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Telephone | 406-413-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 3640 SINCLAIR SHORES RD
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City | CUMMING
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State | GA
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Zip | 30041-5411
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Country | US
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Telephone | 406-413-6200
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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 | DANIEL JOSEPH MUSSER
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Credential | MD
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Telephone | 406-413-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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