Provider Demographics
NPI:1043756109
Name:ALPINE PRIME PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:ALPINE PRIME PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCKLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:406-441-4445
Mailing Address - Street 1:330 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3740
Mailing Address - Country:US
Mailing Address - Phone:406-441-4445
Mailing Address - Fax:406-441-4447
Practice Address - Street 1:330 11TH AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3740
Practice Address - Country:US
Practice Address - Phone:406-441-4445
Practice Address - Fax:406-441-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty