Organization
VANCE THOMPSON VISION MT PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT JENSEN (CEO)
(605) 361-3937
Entity
Organization
Contact information
Practice address
1925 N 22ND AVE, BOZEMAN, MT 59718-7020
(877) 522-3937
Mailing address
3101 W 57TH ST, SIOUX FALLS, SD 57108-3162
(605) 361-3937
(605) 371-7199
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
MED-PHYS-LIC-57511
MT
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
06/06/2017
Last updated
01/07/2021
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