Provider Demographics
NPI:1407228265
Name:BRIDGER ORTHOPEDIC WALK IN CLINIC PC
Entity Type:Organization
Organization Name:BRIDGER ORTHOPEDIC WALK IN CLINIC PC
Other - Org Name:BRIDGER ORTHOPEDIC ACUTE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:STRICKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-522-1144
Mailing Address - Street 1:1450 ELLIS ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8812
Mailing Address - Country:US
Mailing Address - Phone:406-587-0122
Mailing Address - Fax:406-587-5548
Practice Address - Street 1:3406 LARAMIE DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-2005
Practice Address - Country:US
Practice Address - Phone:406-587-0122
Practice Address - Fax:406-587-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty