Provider Demographics
NPI:1114364379
Name:MICHEL, BRYAN (DPT)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:MICHEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 2ND ST E STE 102
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2447
Mailing Address - Country:US
Mailing Address - Phone:406-730-2224
Mailing Address - Fax:406-730-2228
Practice Address - Street 1:214 2ND ST E STE 102
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2447
Practice Address - Country:US
Practice Address - Phone:406-730-2224
Practice Address - Fax:406-730-2228
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT5717225100000X
MTPTP-PT-LIC-21924225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist