Avery, Jack H

Avery, Jack H is an individual health care provider with primary practice located at 3510 Ptarmigan Ln , Helena MT 59602-0553. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Radiologic Technologist, which is considered as his primary health care specialty. Avery, Jack H can be contacted via phone (406) 449-3750.

Contact Information

Primary practice address
3510 Ptarmigan Ln Helena MT 59602-0553
Phone: (406) 449-3750
Fax: (406) 449-3752
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Radiologic Technologist 247100000X 1019 Montana

Profile Details

NPI number 1962586370
LBN Legal business name Avery, Jack H
Credentials RT (R) (MRI)(QM)(CT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Nov 16th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962586370 NPPES
Montana MEDICAID 0760123

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