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Individual

BRODIE ROBERT LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTD, OTR/L

Contact information

Practice address
301 EDELWEISS DR STE 7, BOZEMAN, MT 59718-3931
(406) 219-2114
(406) 219-2145
Mailing address
952 SAXON WAY APT D, BOZEMAN, MT 59718-6536
(406) 439-3676

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
MT
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary
MT

Other

Enumeration date
11/22/2024
Last updated
11/22/2024
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