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Organization

UNIVERSITY OF MONTANA

Active
Parent organization
UNIVERSITY OF MONTANA
Other names
Rural Institute-MonTECH
Organization subpart
Yes

Provider details

NPI number
Legal business name
UNIVERSITY OF MONTANA
Authorized official
MR. MARTIN E. BLAIR PH.D. (EXECUTIVE DIRECTOR)
(406) 243-4779
Entity
Organization

Contact information

Practice address
700 SW HIGGINS AVE.,, SUITE 250, MISSOULA, MT 59803-3602
(406) 243-5769
(406) 243-4730
Mailing address
700 SW HIGGINS AVE.,, SUITE 250, MISSOULA, MT 59803-3602
(406) 243-5769
(406) 243-4730

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
235Z00000X
Speech-Language Pathologist
332BC3200X
Customized Equipment (DME)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005602095
MT
05
600627
MT
Enumeration date
02/05/2007
Last updated
10/31/2013
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