Individual
LARRY W WUNDROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, AUDIOLOGIST
Contact information
Practice address
601 S ORANGE ST, MISSOULA, MT 59801-2611
(406) 549-1951
(406) 542-5682
Mailing address
601 S ORANGE ST, MISSOULA, MT 59801-2611
(406) 549-1951
(406) 542-5682
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
178
MT
237600000X
Audiologist-Hearing Aid Fitter
114
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029108
BCBBSMT
MT
05
—
0531076
—
MT
05
—
0569257
—
MT
05
—
1831233790
—
MT
Enumeration date
02/16/2007
Last updated
07/21/2010
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