Individual
MOZELLE M SOULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
937 HIGHLAND BLVD STE 5510, BOZEMAN, MT 59715-6916
(406) 414-3959
Mailing address
915 HIGHLAND BLVD, ATTN PFS CREDENTIALING, BOZEMAN, MT 59715-6902
(406) 414-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15524
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053372821
—
MT
Enumeration date
03/31/2006
Last updated
04/09/2025
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