Organization
JON KOLSTAD O D, P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON CHRISTOPHER KOLSTAD O.D. PC (OWNER)
(406) 228-8641
Entity
Organization
Contact information
Practice address
630 3RD AVE S, GLASGOW, MT 59230-2407
(406) 228-8641
(406) 228-2094
Mailing address
PO BOX 672, 630 3RD AVE. SO., GLASGOW, MT 59230-0672
(406) 228-8641
(406) 228-2094
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
616
MT
152WC0802X
Corneal and Contact Management Optometrist
616
MT
152WL0500X
Low Vision Rehabilitation Optometrist
616
MT
152WP0200X
Pediatric Optometrist
616
MT
152WS0006X
Sports Vision Optometrist
616
MT
152WV0400X
Vision Therapy Optometrist
616
MT
152WX0102X
Occupational Vision Optometrist
616
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000480012
—
MT
05
—
0000482647
—
MT
05
—
0000483565
—
MT
Enumeration date
08/10/2007
Last updated
01/03/2008
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