# CARL THORNBLADE, MD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Montana Allergy Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750557690
- **Authorized official:** DR. CARL EDWARD THORNBLADE MD (ALLERGIST/OWNER)
- **Authorized official phone:** (406) 728-6472

## Contact information

- **Practice address:** 2801 GREAT NORTHERN LOOP STE 101, MISSOULA, MT 59808
- **Practice address phone:** (406) 728-6472
- **Practice address fax:** (406) 728-9175
- **Mailing address:** 2801 GREAT NORTHERN LOOP STE 101, MISSOULA, MT 59808-1745
- **Mailing address phone:** (406) 728-6472
- **Mailing address fax:** (406) 728-9175

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | 11594 | MT | Yes |

## Other

- **Enumeration date:** 04/30/2008
- **Last updated:** 02/04/2019