NPI 1043680994

Tom Osborn

Practitioner Contractor Black Eagle, MT

Practice location

Address: 1120 25th Ave, Black Eagle, MT 59414-1037
Phone: (406) 452-9834
Fax: (406) 453-3940

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 193766 (MT)

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Registry record

NPI: 1043680994
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Oct 2015
Record last updated: 5 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.