Provider Demographics
NPI:1598898959
Name:WATSCHKE, ANGELA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:WATSCHKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:409 N 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-1809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:875 S COTTONWOOD RD STE 300
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-4221
Practice Address - Country:US
Practice Address - Phone:406-414-4100
Practice Address - Fax:406-414-4199
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2043PT2251P0200X
MT20432251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics