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Individual

RICHARD DALE KUNTZELMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
205 HAGGERTY LN, SUITE 100, BOZEMAN, MT 59715-8800
(406) 585-7399
Mailing address
205 HAGGERTY LN, SUITE 100, BOZEMAN, MT 59715-8800
(406) 585-7399

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
566
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60605
BLUE CROSS BLUE SHIELD
MT
Enumeration date
12/19/2006
Last updated
07/08/2007
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