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1194743948
BRENT ALAN DODGE
MISSOULA, MT
NPI
1194743948
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MT 709)
Enumeration Date
2006-07-18
Last Update Date
2014-10-02
Business Address
Mr. BRENT ALAN DODGE PT
5000 BLUE MOUNTAIN RD
MISSOULA, MT 59804-9207
Phone number: 406-251-2323
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Mailing Address
Mr. BRENT ALAN DODGE PT
5000 BLUE MOUNTAIN RD
MISSOULA, MT 59804-9207
Phone number: 406-251-2323
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