Provider Demographics
NPI:1073775060
Name:BARTOSIK, SHANON (CMT)
Entity Type:Individual
Prefix:
First Name:SHANON
Middle Name:
Last Name:BARTOSIK
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6446 HWY 93 SOUTH
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59912
Mailing Address - Country:US
Mailing Address - Phone:406-862-7655
Mailing Address - Fax:406-862-9750
Practice Address - Street 1:6446 HWY 93 S
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-8237
Practice Address - Country:US
Practice Address - Phone:406-862-7655
Practice Address - Fax:406-862-9750
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist