| Ideal Balance Pllc | |
|
1532 Ellis St Ste 104 Bozeman MT 59715-8809 | |
| (509) 524-9903 | |
| (888) 745-2096 |
| Full Name | Ideal Balance Pllc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1532 Ellis St Ste 104, Bozeman, Montana |
| Authorized Official Name and Position | Viktoriya R Broyan (SPECIAL PROJECTS MANAGER) |
| Authorized Official Contact | 5095709322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Balance Pllc 8514 W Gage Blvd Ste G Kennewick WA 99336-8108 Ph: (509) 524-9903 | Ideal Balance Pllc 1532 Ellis St Ste 104 Bozeman MT 59715-8809 Ph: (509) 524-9903 |
| NPI Number | 1699303644 |
|---|---|
| Provider Enumeration Date | 03/27/2020 |
| Last Update Date | 03/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699303644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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