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Contact Information

MONTANA SPORT AND SPINE LLC
925 HIGHLAND BLVD, SUITE 1130
BOZEMAN SPORT AND SPINE LLC
BOZEMAN, MT59715-6900
 Phone: 406-522-9067
 Fax: 406-522-9074
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for MONTANA SPORT AND SPINE LLC

NPI Number 1013004241
LBN Legal business name MONTANA SPORT AND SPINE LLC
Authorized official BRADLEY AYLOR - (PROPRIETER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/09/2006
Last updated 07/23/2013 - About 13 years ago
Identifiers
MT License # 10381
MT Other 000099205 BLUE CROSS BLUE SHIELD
MT Other DC7699 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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