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Individual

RACHAEL M BEATTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
1200 W KENT AVE STE 101, MISSOULA, MT 59801-6609
(406) 272-0453
(406) 221-3754
Mailing address
1200 W KENT AVE STE 101, MISSOULA, MT 59801-6609
(406) 272-0453
(406) 221-3754

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010206
IL
152W00000X
Optometrist
Primary
816
MT
152WP0200X
Pediatric Optometrist
046010206
IL
152WP0200X
Pediatric Optometrist
816
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046010206
IL
Enumeration date
06/29/2009
Last updated
06/28/2021
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