Provider Demographics
NPI:1073750576
Name:LATCHAM, DEANN MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEANN
Middle Name:MARIE
Last Name:LATCHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-0326
Mailing Address - Country:US
Mailing Address - Phone:406-730-2411
Mailing Address - Fax:
Practice Address - Street 1:400 VETERANS DR.
Practice Address - Street 2:MONTANA STATE VETERAN'S HOME
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-0256
Practice Address - Country:US
Practice Address - Phone:406-892-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT882PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist