Provider Demographics
NPI:1235820739
Name:TREASURE STATE ORTHOTIC & PROSTHETIC CLINIC, INC.
Entity Type:Organization
Organization Name:TREASURE STATE ORTHOTIC & PROSTHETIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR/AP DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:MURFITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-585-1440
Mailing Address - Street 1:1648 ELLIS ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8811
Mailing Address - Country:US
Mailing Address - Phone:406-585-1440
Mailing Address - Fax:
Practice Address - Street 1:2405 BROOKS ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7869
Practice Address - Country:US
Practice Address - Phone:406-493-0433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOTICS AND PROSTHETICS OF MONTANA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier