Organization
MISSOULA BONE & JOINT SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA SPENCER CEO (CEO)
(406) 721-4436
Entity
Organization
Contact information
Practice address
2360 MULLAN RD, SUITE B, MISSOULA, MT 59808-1811
(406) 542-9695
(406) 542-9703
Mailing address
2360 MULLAN RD, SUITE B, MISSOULA, MT 59808-1811
(406) 542-9695
(406) 542-9703
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000351084
—
MT
Enumeration date
05/28/2006
Last updated
04/23/2014
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