Provider Demographics
NPI:1043587215
Name:PFEIFER, EMILY M (PTA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 NYLIC LN
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-4062
Mailing Address - Country:US
Mailing Address - Phone:406-490-7562
Mailing Address - Fax:
Practice Address - Street 1:4 NYLIC LN
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4062
Practice Address - Country:US
Practice Address - Phone:406-490-7562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1639126303261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy