Provider Demographics
NPI:1497531347
Name:KILMURRAY, JOSHUA WEAS (L AC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:WEAS
Last Name:KILMURRAY
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:JAMES
Other - Last Name:WEAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:875 BRIDGER DR STE J
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-2303
Mailing Address - Country:US
Mailing Address - Phone:406-585-9113
Mailing Address - Fax:
Practice Address - Street 1:875 BRIDGER DR STE J
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-2303
Practice Address - Country:US
Practice Address - Phone:406-585-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT129283171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist