Provider Demographics
NPI:1538118674
Name:MCBAIN, LAURA J (OT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:J
Last Name:MCBAIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:J
Other - Last Name:RINGELSTETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1113 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3653
Mailing Address - Country:US
Mailing Address - Phone:406-579-9666
Mailing Address - Fax:
Practice Address - Street 1:11 W MAIN ST
Practice Address - Street 2:SUITE 218
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3700
Practice Address - Country:US
Practice Address - Phone:406-388-4988
Practice Address - Fax:406-388-6188
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT931225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3402125Medicaid
MT662640OtherBCBS
MT000050872Medicare ID - Type Unspecified