Basic Information
| Provider Information | |||||||||
| NPI: | 1134281876 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANTZ | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 W KENT AVE | ||||||||
| Address2: | |||||||||
| City: | MISSOULA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598016772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4065491951 | ||||||||
| FaxNumber: | 4065425682 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 W KENT AVE | ||||||||
| Address2: | |||||||||
| City: | MISSOULA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598016772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4065493277 | ||||||||
| FaxNumber: | 4065413811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2006 | ||||||||
| LastUpdateDate: | 09/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 140 | MT | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 463 | MT | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 0562785 | 05 | MT | MEDICAID | 290528 | 01 | MT | BCBSMT | OTHER | 0534888 | 05 | MT | MEDICAID | 1134281876 | 05 | MT | MEDICAID |