Organization
ROCKY MOUNTAIN EYE SURGERY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN L PETERSON CEO (CEO)
(406) 541-3937
Entity
Organization
Contact information
Practice address
700 WEST KENT, MISSOULA, MT 59801
(406) 541-3883
(406) 541-3884
Mailing address
700 W KENT AVE, MISSOULA, MT 59801-6772
(406) 541-3806
(406) 541-3811
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
11789
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3507569
—
MT
01
—
60112
BC
MT
Enumeration date
08/10/2006
Last updated
04/20/2021
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