| NAME |
TRAVIS W ATKINS VA CLINIC |
| STATE |
MONTANA |
| STREET ADDR. 1 |
1101 E MAIN ST STE 201 |
| CITY |
BOZEMAN |
| ZIP |
59715-3956 |
| OFFICIAL VA NAME |
TRAVIS W ATKINS VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
BOZEMAN VA CLINIC |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1720039464
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
MOUNTAIN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
436GD |
| HISTORY |
-
- STREET ADDR. 1 (CHANGED FROM): 300 NORTH WILLSON, SUITE 703G
- CITY (CHANGED FROM): BOZEMAN
- STATE (CHANGED FROM): MONTANA
- ZIP (CHANGED FROM): 59715-3551
|
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1720039464
-
- CODING SYSTEM: VASTANUM
- ID: 436GD
-
- CODING SYSTEM: CLIA
- ID: 27D1002262
|
