| NPI | 1922008077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN A JACOBSON Partner 406-728-6101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 225100000X Physical Therapist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2019-05-15 |