| NPI | 1457978983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN R BULLOCK Physical Therapist/Owner 406-426-1560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2024-01-30 |