Provider Demographics
NPI:1134649478
Name:TORGERSON, KAILEY (DPT)
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:TORGERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAILEY
Other - Middle Name:
Other - Last Name:EDGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3150 N MONTANA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-7804
Mailing Address - Country:US
Mailing Address - Phone:406-502-1782
Mailing Address - Fax:406-502-1783
Practice Address - Street 1:3150 N MONTANA AVE STE D
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-7804
Practice Address - Country:US
Practice Address - Phone:406-502-1782
Practice Address - Fax:406-502-1783
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-12983208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT100015239Medicaid