Provider Demographics
NPI:1881710143
Name:BONE HEALTH AWARENESS CENTER, INC.
Entity type:Organization
Organization Name:BONE HEALTH AWARENESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STAPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, LPH, CDT
Authorized Official - Phone:406-756-2663
Mailing Address - Street 1:1280 BURNS WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3110
Mailing Address - Country:US
Mailing Address - Phone:406-756-2663
Mailing Address - Fax:406-756-2664
Practice Address - Street 1:1280 BURNS WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3110
Practice Address - Country:US
Practice Address - Phone:406-756-2663
Practice Address - Fax:406-756-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8862471B0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Single Specialty