Provider Demographics
NPI:1275612707
Name:MCDOWELL, MILICA G (DPT)
Entity Type:Individual
Prefix:
First Name:MILICA
Middle Name:G
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 E MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3808
Mailing Address - Country:US
Mailing Address - Phone:406-585-3701
Mailing Address - Fax:
Practice Address - Street 1:1648 ELLIS ST STE 201
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8811
Practice Address - Country:US
Practice Address - Phone:406-585-3701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000050739Medicare ID - Type UnspecifiedPHYSICAL THERAPIST