MEDICARE: DOCHARDY.COM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	MT624	MT

General Provider Information

NPI Number	:	1437342235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCHARDY.COM LLC

Provider Business Mailing Address
First Line	:	12 OLD MONTANA STATE HWY
Second Line	:
City	:	MONTANA CITY
State	:	MT
Zip	:	59634-9687
Country	:	US
Telephone Number	:	406-442-2020
Fax Number	:	406-442-0101

Provider Business Practice Location Address
First Line	:	12 OLD MONTANA STATE HWY
Second Line	:
City	:	MONTANA CITY
State	:	MT
Zip	:	59634-9687
Country	:	US
Telephone Number	:	406-442-2020
Fax Number	:	406-442-0101

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. DAVID S HARDY
Credential	:	O.D.
Telephone Number	:	406-442-2020

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	02/02/2011

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