Provider Demographics
NPI:1609548080
Name:ROSALES, HANNAH CLINE (PTA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:CLINE
Last Name:ROSALES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 SAINT JOHNS AVE APT G33
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4796
Mailing Address - Country:US
Mailing Address - Phone:984-444-6734
Mailing Address - Fax:
Practice Address - Street 1:3572 HESPER RD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6891
Practice Address - Country:US
Practice Address - Phone:406-413-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21545225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant