| NPI | 1558679712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN JACOBSON Managing Partner 406-728-6101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand |
| 2251S0007X Physical Therapist, Sports | |
| 2251X0800X Physical Therapist, Orthopedic | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2019-05-15 |