Provider Demographics
NPI:1760509384
Name:NESBIT, IAN ADDISON (NATUROPATH ND)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:ADDISON
Last Name:NESBIT
Suffix:
Gender:M
Credentials:NATUROPATH ND
Other - Prefix:
Other - First Name:IAN
Other - Middle Name:ADDISON
Other - Last Name:NESBIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:PO BOX 4074
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-4074
Mailing Address - Country:US
Mailing Address - Phone:406-541-7672
Mailing Address - Fax:406-541-0672
Practice Address - Street 1:2016 STRAND AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5435
Practice Address - Country:US
Practice Address - Phone:406-728-0978
Practice Address - Fax:406-728-0978
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTAHC-NAT-LIC-47OtherALTERNATIVE HEALTH BOARD
MTAHC-NAT-LIC-47OtherALTERNATIVE HEALTH BOARD