Provider Demographics
NPI:1568451151
Name:LANGFORD, BRIAN J (DPT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 EQUESTRIAN LN
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-8809
Mailing Address - Country:US
Mailing Address - Phone:406-219-2383
Mailing Address - Fax:
Practice Address - Street 1:3717 EQUESTRIAN LN
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-8809
Practice Address - Country:US
Practice Address - Phone:406-219-2383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO77462251X0800X
MT151402251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic