Provider Demographics
NPI:1609438696
Name:SMITH, CONOR (DPT)
Entity Type:Individual
Prefix:DR
First Name:CONOR
Middle Name:
Last Name:SMITH
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 1:3150 N MONTANA AVE
Mailing Address - Street 2:STE D
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-7804
Mailing Address - Country:US
Mailing Address - Phone:406-502-1782
Mailing Address - Fax:406-502-1783
Practice Address - Street 1:701 HELENA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3645
Practice Address - Country:US
Practice Address - Phone:406-442-4325
Practice Address - Fax:800-934-8039
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT17129225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist