| NPI | 1720375595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA JOHNSON Physical Therapist 406-781-2247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2023-11-08 |