MEDICARE: ORTHOPAEDIC NEURO INSTITUTE SURGICAL CENTER, 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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1508163700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPAEDIC NEURO INSTITUTE SURGICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	1739 SPRING CREEK LANE
Second Line	:	SUITE 100
City	:	BILLINGS
State	:	MT
Zip	:	59102
Country	:	US
Telephone Number	:	615-301-8143
Fax Number	:	615-301-8152

Provider Business Practice Location Address
First Line	:	1739 SPRING CREEK LANE
Second Line	:	SUITE 100
City	:	BILLINGS
State	:	MT
Zip	:	59102
Country	:	US
Telephone Number	:	615-301-8143
Fax Number	:	615-301-8152

Authorized Official
Title or Position	:	BOARD MEMBER/OWNER
Name	:	MS. CATHERINE W KOWALSKI
Credential	:	RN, MS
Telephone Number	:	615-301-8143

Provider Enumeration Date	:	02/24/2011
Last Update Date	:	03/02/2011

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