Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 10259 | MT |
NPI | 1013086198 |
---|---|
Provider Name | Blackshear Morrison Bryan |
First Address | Billings, MT 59101-0127 |
Second Address | Billings, MT 59101-0127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 26/07/2007 |