# ELKHORN MOUNTAIN HEALTH SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boulder Medical Clinic Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043396054
- **Authorized official:** MR. LEE S SWANSON (VICE PRESIDENT)
- **Authorized official phone:** (406) 225-4201

## Contact information

- **Practice address:** 214 SOUTH MAIN, BOULDER, MT 59632
- **Practice address phone:** (406) 225-4201
- **Practice address fax:** (406) 225-9161
- **Mailing address:** 214 SOUTH MAIN, BOULDER, MT 59632-0028
- **Mailing address phone:** (406) 225-4201
- **Mailing address fax:** (406) 225-9161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 04/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 720291 | — | MT |