Provider Demographics
NPI:1215387477
Name:PIVOT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PIVOT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HODGSKISS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:406-590-5158
Mailing Address - Street 1:15TH 6TH ST SOUTH
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:MT
Mailing Address - Zip Code:59436-0457
Mailing Address - Country:US
Mailing Address - Phone:406-467-3800
Mailing Address - Fax:406-467-3828
Practice Address - Street 1:15TH 6TH ST SOUTH
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:MT
Practice Address - Zip Code:59436-0457
Practice Address - Country:US
Practice Address - Phone:406-467-3800
Practice Address - Fax:406-467-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty