| Philip H Bornstein Etal Ptr | |
|
125 Bank St Suite 310 Missoula MT 59802-4407 | |
| (406) 549-7325 | |
| Not Available |
| Full Name | Philip H Bornstein Etal Ptr |
|---|---|
| Speciality | Psychologist |
| Location | 125 Bank St, Missoula, Montana |
| Authorized Official Name and Position | Philip H Bornstein (OWNER) |
| Authorized Official Contact | 4065497325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip H Bornstein Etal Ptr 125 Bank St Suite 310 Missoula MT 59802-4407 Ph: (406) 549-7325 | Philip H Bornstein Etal Ptr 125 Bank St Suite 310 Missoula MT 59802-4407 Ph: (406) 549-7325 |
| NPI Number | 1750688461 |
|---|---|
| Provider Enumeration Date | 02/15/2011 |
| Last Update Date | 03/31/2011 |
| Medicare PECOS PAC ID | 6901081868 |
|---|---|
| Medicare Enrollment ID | O20110420000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750688461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Philip H Bornstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154470714 PECOS PAC ID: 9032394903 Enrollment ID: I20110420000163 |
| Provider Name | Marcy T Bornstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538219068 PECOS PAC ID: 3678758547 Enrollment ID: I20110425000788 |
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