Individual
DR. TEL MICHAEL TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
24215 NORRIS RD, BOZEMAN, MT 59718-8187
(406) 580-6553
Mailing address
24215 NORRIS RD, BOZEMAN, MT 59718
(406) 580-6553
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2897
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477909646
—
MT
05
—
1477909646
—
NM
Enumeration date
05/06/2016
Last updated
06/08/2017
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