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Organization

JON C KOLSTAD OD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JON C KOLSTAD O.D. (OPTOMETRIST/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
630 3RD AVE S, GLASGOW, MT 59230-2407
(406) 228-8641
(406) 228-2094

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
616MT
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1639361058
MT
Enumeration date
09/13/2012
Last updated
04/15/2014
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