Organization Name: | ROCKY MOUNTAIN VEIN CLINIC BOZEMAN, INC |
NPI Number: | 1174962542 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES L JOHNSON (OWNER) |
Mailing Address: | 822 Stoneridge Dr #2 Bozeman |
State: | MT US |
Postal Code: | 597187047 |
Phone Number: | 4062528346 |
Fax Number: | 4066568303 |
NPI Enumeration Date: | 06/19/2013 |
NPI Last Update Date: | 06/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 10772 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |