| NPI | 1477082709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C BOERSMA Owner/President 406-522-7488 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2019-03-20 |