Organization
LARRY J. BONDERUD, OD
Active
Parent organization
LARRY J BONDERUD OD, DBA NORTHERN MONTANA EYECARE
Other names
Northern Montana Eyecare
Organization subpart
Yes
Provider details
NPI number
Legal business name
LARRY J BONDERUD OD, DBA NORTHERN MONTANA EYECARE
Authorized official
LEANN APPLEY (OFFICE MANAGER)
(406) 434-5196
Entity
Organization
Contact information
Practice address
865 OILFIELD AVE STE 1, SHELBY, MT 59474-2702
(406) 434-5196
(406) 434-5197
Mailing address
865 OILFIELD AVE STE 1, SHELBY, MT 59474-2702
(406) 434-5196
(406) 434-5197
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
393
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0481389
—
MT
Enumeration date
05/22/2018
Last updated
06/16/2018
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