Laine, Ted B.
Laine, Ted B. is an sole proprietor health care provider with primary practice located at 2825 Fort Missoula Rd Ste 201, Missoula MT 59804-7420. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Laine, Ted B. can be contacted via phone (406) 721-5566.Contact Information
Primary practice address
2825 Fort Missoula Rd Ste 201
Missoula MT 59804-7420
Phone: (406) 721-5566
Fax: (406) 728-1868
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 4247 | Montana |
Profile Details
| NPI number | 1043294572 |
|---|---|
| LBN Legal business name | Laine, Ted B. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043294572 | NPPES |
| Montana | MEDICAID | 005-6472 | |
| Montana | MEDICAID | 1383801 | |
| Montana | Other | 12790 |
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