Provider Demographics
NPI:1609696962
Name:STRAND, ADAM EARL
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:EARL
Last Name:STRAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SHELTER CV # 1251
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:MT
Mailing Address - Zip Code:59922-9689
Mailing Address - Country:US
Mailing Address - Phone:406-709-2046
Mailing Address - Fax:
Practice Address - Street 1:31 SHELTER CV # 1251
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:MT
Practice Address - Zip Code:59922-9689
Practice Address - Country:US
Practice Address - Phone:406-709-2046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty