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1639467012
SAMANTHA JO MODDERMAN
KALISPELL, MT
NPI
1639467012
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MT 2439)
Enumeration Date
2011-07-19
Last Update Date
2011-07-19
Business Address
Ms. SAMANTHA JO MODDERMAN PT,DPT
1234 WHITEFISH STAGE
KALISPELL, MT 59901-2753
Phone number: 406-756-7878
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Mailing Address
Ms. SAMANTHA JO MODDERMAN PT,DPT
1234 WHITEFISH STAGE ROAD
KALISPELL, MT 59901-2753
Phone number: 406-756-7878
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