Provider Demographics
NPI:1093239139
Name:ALEPH, PC
Entity Type:Organization
Organization Name:ALEPH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-541-4673
Mailing Address - Street 1:2120 SOUTH RESERVE
Mailing Address - Street 2:PMB 117
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1716 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6821
Practice Address - Country:US
Practice Address - Phone:406-541-4673
Practice Address - Fax:406-728-5358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEPH, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty