Provider Demographics
NPI:1710453618
Name:BOESON RESEARCH LLC
Entity Type:Organization
Organization Name:BOESON RESEARCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LOOSLI
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:208-557-9898
Mailing Address - Street 1:2831 FORT MISSOULA RD STE 232
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7479
Mailing Address - Country:US
Mailing Address - Phone:406-763-8833
Mailing Address - Fax:406-763-0001
Practice Address - Street 1:2831 FORT MISSOULA RD STE 232
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-7479
Practice Address - Country:US
Practice Address - Phone:406-763-8833
Practice Address - Fax:406-763-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch