Provider Demographics
NPI:1396632493
Name:CULBERTSON, COLLEEN (OD)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:CULBERTSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 ROSEBUD RD
Mailing Address - Street 2:
Mailing Address - City:ABSAROKEE
Mailing Address - State:MT
Mailing Address - Zip Code:59001-6212
Mailing Address - Country:US
Mailing Address - Phone:406-328-4565
Mailing Address - Fax:
Practice Address - Street 1:305 W PARK ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-2630
Practice Address - Country:US
Practice Address - Phone:406-222-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOPT-OPT-LIC-5593152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist