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MISSOULA OSTEOPATHIC CLINIC PLLC NPI 1912133885


NPI Information

NPI: 1912133885
Provider Name: MISSOULA OSTEOPATHIC CLINIC, PLLC
Classification: Neuromusculoskeletal Medicine & OMM - 204D00000X
Entity Type: Organization

CLIA Number: 27D2083938

Address:
341 W PINE ST
MISSOULA, MT
ZIP 59802
Phone: (406) 327-0269
Get Directions

MISSOULA OSTEOPATHIC CLINIC, PLLC is a neuromusculoskeletal medicine omm in Missoula, MT. The provider is the Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. MISSOULA OSTEOPATHIC CLINIC, PLLC NPI is 1912133885. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

341 W PINE ST
MISSOULA, MT
ZIP 59802-119
Phone: (406) 327-0269
Fax: (406) 327-0264

The provider's authorized official is Sam A Wallace .
The authorized official title is Owner/physician and has the following contact phone number (406) 327-0269.

The CLIA number assigned to this NPI record is 27D2083938 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2009 and was last updated on 6/5/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204D00000XNeuromusculoskeletal Medicine & OMM11754MONTANANo
2204D00000XNeuromusculoskeletal Medicine & OMM11801MONTANANo
3204D00000XNeuromusculoskeletal Medicine & OMM8667MONTANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000081647MEDICARE PINMONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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