| NPI | 1124043633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CARNINE Owner 406-531-5918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 110326-2401) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2024-12-02 |