Organization
NORTHERN ROCKIES ORTHOPAEDICS, PLLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN A JACOBSON MD (PARTNER)
(406) 728-6101
Entity
Organization
Contact information
Practice address
2740 SOUTH AVENUE WEST, SUITE 101, MISSOULA, MT 59804-5114
(406) 728-6101
(406) 721-3278
Mailing address
2740 SOUTH AVE W STE 101, MISSOULA, MT 59804-5137
(406) 728-6101
(406) 721-3278
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
225100000X
Physical Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069155001
DMERC
MT
Enumeration date
07/29/2005
Last updated
10/22/2024
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