Individual
DR. LISA MARIE TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
777 E MAIN ST, SUITE 101, BOZEMAN, MT 59715-3808
(406) 595-0852
Mailing address
PO BOX 1779, BOZEMAN, MT 59771-1779
(406) 595-0852
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11366
MT
208100000X
Physical Medicine & Rehabilitation Physician
MT1136
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8460164
—
WA
01
—
8860422
MEDICARE
MT
Enumeration date
06/12/2006
Last updated
08/08/2017
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