Organization
EYE CLINIC OF GREAT FALLS, PC
Active
Other names
Benton Eye Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A KUMM OPTOMETRIST OD (PARTNER OWNER)
(406) 452-9507
Entity
Organization
Contact information
Practice address
1516 CHOUTEAU STREET, FORT BENTON, MT 59442
(406) 622-5449
(406) 622-6188
Mailing address
PO BOX 249, FORT BENTON, MT 59442
(406) 622-5449
(406) 622-6188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0483730
—
MT
01
—
25781
BLUE CROSS BLUE SHIELD
MT
Enumeration date
02/08/2007
Last updated
10/12/2007
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