Individual
MRS. JUSTINE M. DEROUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1006 W MAIN ST, BOZEMAN, MT 59715-3219
(406) 414-4800
Mailing address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 414-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
451
MT
Other
Enumeration date
03/03/2006
Last updated
04/15/2025
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