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2023 Stadium Dr Ste 2b Bozeman MT 59715-0613 | |
| (406) 579-0985 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2023 Stadium Dr Ste 2b, Bozeman, Montana |
| Authorized Official Name and Position | Michael Alan Stamm (MEMBER) |
| Authorized Official Contact | 4065797718 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2023 Stadium Dr Ste 2b Bozeman MT 59715-0613 Ph: (406) 579-0985 | 2023 Stadium Dr Ste 2b Bozeman MT 59715-0613 Ph: (406) 579-0985 |
| NPI Number | 1982131520 |
|---|---|
| Provider Enumeration Date | 05/14/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 12/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982131520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4425 (Montana) | Primary |
| 101YP2500X | Counselor - Professional | 1570 (Montana) | Secondary |
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