| |
945 Wyoming Street, Suite 135, Missoula, MT 59801 | |
(406) 544-6090 | |
(800) 886-0200 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 945 Wyoming Street, Missoula, Montana |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558737551 | NPI | - | NPPES |
1164591046 | Other | MT | NPI |
011000682 | Other | MT | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 432 (Montana) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
91 Campus Dr, Pmb 1217, Missoula, MT 59801-4492 Ph: (406) 544-6090 | 945 Wyoming Street, Suite 135, Missoula, MT 59801 Ph: (406) 544-6090 |