Individual
THEODORE R PREISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
937 HIGHLAND BLVD STE 5410, BOZEMAN, MT 59715-6916
(406) 414-3610
Mailing address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 414-5000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MT476
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000900133
BCBS
—
05
—
1528193265
—
MT
Enumeration date
02/22/2007
Last updated
04/15/2025
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