Provider Demographics
NPI:1487866539
Name:KEY, MILES ROE (MSPT)
Entity Type:Individual
Prefix:MR
First Name:MILES
Middle Name:ROE
Last Name:KEY
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
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Mailing Address - Street 1:105 ROLLING GREEN PL
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-2434
Mailing Address - Country:US
Mailing Address - Phone:406-531-6896
Mailing Address - Fax:406-540-1191
Practice Address - Street 1:105 ROLLING GREEN PL
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-2434
Practice Address - Country:US
Practice Address - Phone:406-531-6896
Practice Address - Fax:406-540-1191
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist