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Organization
MONTANA SPORT AND SPINE LLC
Active
Organization
MONTANA SPORT AND SPINE LLC
Active
Other names
Bozeman Sport and Spine LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY L. AYLOR M.D. (PROPRIETER)
(406) 522-9067
Entity
Organization
Contact information
Practice address
925 HIGHLAND BLVD, SUITE 1130, BOZEMAN SPORT AND SPINE LLC, BOZEMAN, MT 59715-6900
(406) 522-9067
(406) 522-9074
Mailing address
925 HIGHLAND BLVD, SUITE 1130, MONTANA SPORT AND SPINE LLC, BOZEMAN, MT 59715-6900
(406) 522-9067
(406) 522-9074
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
10381
MT
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
10/09/2006
Last updated
07/23/2013
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