Provider Demographics
NPI:1467519926
Name:MANUAL ORTHOPEDIC & SPORTS THERAPY
Entity Type:Organization
Organization Name:MANUAL ORTHOPEDIC & SPORTS THERAPY
Other - Org Name:MOST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MR
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:MAITLAND
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:406-249-6678
Mailing Address - Street 1:576 SPOKANE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2781
Mailing Address - Country:US
Mailing Address - Phone:406-862-2348
Mailing Address - Fax:
Practice Address - Street 1:576 SPOKANE AVE
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2781
Practice Address - Country:US
Practice Address - Phone:406-862-2348
Practice Address - Fax:406-862-6690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2023-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT314261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy