Montana Neurocare Pllc | |
2825 Fort Missoula Rd Ste 301 Missoula MT 59804-7403 | |
(406) 327-4688 | |
(406) 327-4291 |
Full Name | Montana Neurocare Pllc |
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Speciality | Clinical Neuropsychologist |
Location | 2825 Fort Missoula Rd Ste 301, Missoula, Montana |
Authorized Official Name and Position | John Robert Harrison (MANAGER) |
Authorized Official Contact | 4063274688 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Montana Neurocare Pllc 2825 Fort Missoula Rd Ste 301 Missoula MT 59804-7403 Ph: (406) 327-4688 | Montana Neurocare Pllc 2825 Fort Missoula Rd Ste 301 Missoula MT 59804-7403 Ph: (406) 327-4688 |
NPI Number | 1346273968 |
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Provider Enumeration Date | 07/08/2006 |
Last Update Date | 09/11/2019 |
Medicare PECOS PAC ID | 4385613884 |
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Medicare Enrollment ID | O20040930001097 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346273968 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
Provider Name | John R Harrison |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1295750636 PECOS PAC ID: 6305815812 Enrollment ID: I20041004001168 |
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