Provider Demographics
NPI:1437311271
Name:BITTINGER, JAMES MICHAEL (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:BITTINGER
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 1:220 S DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1759
Mailing Address - Country:US
Mailing Address - Phone:208-265-4514
Mailing Address - Fax:208-263-3789
Practice Address - Street 1:220 S DIVISION AVE
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-1759
Practice Address - Country:US
Practice Address - Phone:208-265-4514
Practice Address - Fax:208-263-3789
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-2335225100000X
VT040.0055310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist