Provider Demographics
NPI:1376704072
Name:ABBOTT, DUAIN ERIC (PT, PHD)
Entity Type:Individual
Prefix:MR
First Name:DUAIN
Middle Name:ERIC
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:396 DAHYITA WAY
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:MT
Mailing Address - Zip Code:59875-9560
Mailing Address - Country:US
Mailing Address - Phone:406-642-3619
Mailing Address - Fax:
Practice Address - Street 1:336 FAIRGROUNDS RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3126
Practice Address - Country:US
Practice Address - Phone:406-375-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13482251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports