| NPI | 1669535928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN VOGELZANG Owner 406-544-5679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: MT 1576PT) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: MT 1576PT) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2014-02-19 |