| NPI | 1013004241 |
|---|---|
| Doing Business As | BOZEMAN SPORT AND SPINE LLC |
| Entity Type | Organization |
| Authorized Contact | BRADLEY L. AYLOR Proprieter 406-522-9067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MT 10381) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2013-07-23 |