Individual
SANDY SHEPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD PC
Contact information
Practice address
700 SOUTH AVE W, STE. G, MISSOULA, MT 59801-8000
(406) 549-4851
(406) 549-8486
Mailing address
700 SOUTH AVE W, STE. G, MISSOULA, MT 59801-8000
(406) 549-4851
(406) 549-8486
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
494
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0482120
—
MT
01
—
27640
BCBS
MT
Enumeration date
01/12/2007
Last updated
05/26/2010
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