Individual
BENJAMIN LLOYD RASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1648 ELLIS ST STE 201, BOZEMAN, MT 59715-8811
(406) 587-8631
(406) 587-1343
Mailing address
1648 ELLIS ST STE 201, BOZEMAN, MT 59715-8811
(406) 587-8631
(406) 587-1343
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01075286A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
MED-PHYS-LIC-87558
MT
390200000X
Student in an Organized Health Care Education/Training Program
11016076A
IN
Other
Enumeration date
06/16/2011
Last updated
09/06/2024
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