Intercity Radiology, PC

NPI #1356390736 in Bozeman, Montana

Provider Information

NPI Number: 1356390736
Entity Type: Organization
Organization Name: Intercity Radiology, PC
Primary Specialty: Specialist
Enumeration Date: May 10, 2006
Last Updated: Sep 4, 2020

Practice Location

Address: 1648 ELLIS ST STE 201
City: Bozeman
State: Montana
ZIP Code: 59715-8811
Phone: (406) 587-8631

Authorized Official

Name: JESSICALEE FANDRICH
Title: CREDENTIALING MANGER
Phone: (406) 587-8631

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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