# MONTANA SPORT AND SPINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bozeman Sport and Spine LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013004241
- **Authorized official:** DR. BRADLEY L. AYLOR M.D. (PROPRIETER)
- **Authorized official phone:** (406) 522-9067

## Contact information

- **Practice address:** 925 HIGHLAND BLVD, SUITE 1130, BOZEMAN SPORT AND SPINE LLC, BOZEMAN, MT 59715-6900
- **Practice address phone:** (406) 522-9067
- **Practice address fax:** (406) 522-9074
- **Mailing address:** 925 HIGHLAND BLVD, SUITE 1130, MONTANA SPORT AND SPINE LLC, BOZEMAN, MT 59715-6900
- **Mailing address phone:** (406) 522-9067
- **Mailing address fax:** (406) 522-9074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 10381 | MT | Yes |
| 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