Individual
BLYTHE LINDSAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1648 ELLIS STREET, SUITE 301, BOZEMAN, MT 59715-8811
(406) 556-9798
(406) 556-9798
Mailing address
1648 ELLIS STREET, SUITE 301, BOZEMAN, MT 59715-8811
(406) 556-9798
(406) 556-9795
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
419
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183833
—
MT
01
—
419
STATE LICENSE
MT
Enumeration date
10/03/2006
Last updated
03/13/2020
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