Organization
LARRY J. BONDERUD, OD
Active
Other names
Northern Montana Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY JAMES BONDERUD OD (OWNER)
(406) 434-5196
Entity
Organization
Contact information
Practice address
19 4TH AVE SW, CONRAD, MT 59425-2339
(406) 271-5517
(406) 271-5518
Mailing address
865 OILFIELD AVE, SHELBY, MT 59474-2702
(406) 434-5196
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
393
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00481389
—
MT
Enumeration date
10/12/2017
Last updated
03/17/2018
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