| NPI | 1295850535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY JAMES BONDERUD Owner 406-434-5196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MT 516) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MT 393) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2010-07-27 |