Individual
JAMES RAYMOND GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
536 S. COTTONWOOD RD, SUITE 103, BOZEMAN, MT 59718-9505
(406) 548-6266
(406) 548-6269
Mailing address
PO BOX 11629, BOZEMAN, MT 59719-1629
(406) 522-7488
(406) 522-7487
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4000
MT
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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