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Individual

MELISSA SUE KNUTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
316 E BABCOCK ST, BOZEMAN, MT 59715-4710
(406) 585-0022
(406) 585-0032
Mailing address
316 E BABCOCK ST, BOZEMAN, MT 59715-4710
(406) 585-0022
(406) 585-0032

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34009672
OH
207Q00000X
Family Medicine Physician
Primary
DO157503
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10024004
WV BWC
WV
01
3029332
MOLINA
OH
05
3029332
OH
05
3810017114
WV
Enumeration date
11/23/2009
Last updated
05/03/2022
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