Provider Demographics
NPI:1568601763
Name:ORTHOPEDICS ONE LLC
Entity Type:Organization
Organization Name:ORTHOPEDICS ONE LLC
Other - Org Name:PEAK ORTHOPEDICS AND SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VELINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-752-1724
Mailing Address - Street 1:1111 BAKER AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2901
Mailing Address - Country:US
Mailing Address - Phone:406-863-9340
Mailing Address - Fax:406-863-9342
Practice Address - Street 1:1111 BAKER AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2901
Practice Address - Country:US
Practice Address - Phone:406-863-9340
Practice Address - Fax:406-863-9342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center