Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 123 | MT |
NPI | 1124359823 |
---|---|
Provider Name | Dr. Tanda Leigh Cook |
First Address | Bozeman, MT 59718-6493 |
Second Address | Bozeman, MT 59718-6493 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2010 |
Last Update Date | 19/01/2010 |