Provider Demographics
NPI:1366489759
Name:ZOMBRO, JOHN KEVIN (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KEVIN
Last Name:ZOMBRO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 E MAIN ST
Mailing Address - Street 2:SUITE DB2
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4730
Mailing Address - Country:US
Mailing Address - Phone:406-585-2902
Mailing Address - Fax:
Practice Address - Street 1:448 E MAIN ST
Practice Address - Street 2:SUITE DB2
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4730
Practice Address - Country:US
Practice Address - Phone:406-585-2902
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist