Organization
BRIAN D. MCCOLLOM, O.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN D. MCCOLLOM O.D. (PRESIDENT)
(406) 466-2802
Entity
Organization
Contact information
Practice address
913 4TH ST NW, CHOTEAU, MT 59422-9123
(406) 466-2802
(406) 466-2732
Mailing address
913 4TH ST NW, CHOTEAU, MT 59422-9123
(406) 466-2802
(406) 466-2732
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
746
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0482817
—
MT
Enumeration date
07/11/2007
Last updated
12/21/2009
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