Individual
CASSIDY L JUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1905 W COLLEGE ST, BOZEMAN, MT 59718-4061
(406) 587-4432
(406) 587-7015
Mailing address
1905 W COLLEGE ST, BOZEMAN, MT 59718-4061
(406) 587-4432
(406) 587-7015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25943
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M011003485
MEDICARE PTAN
MT
Enumeration date
11/08/2007
Last updated
07/08/2020
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