Provider Demographics
NPI:1619047644
Name:HOSEK, LINDA L (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:HOSEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 BAKER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2908
Mailing Address - Country:US
Mailing Address - Phone:406-862-7997
Mailing Address - Fax:406-862-7987
Practice Address - Street 1:1111 BAKER AVE STE 2
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2908
Practice Address - Country:US
Practice Address - Phone:406-862-7997
Practice Address - Fax:406-862-7987
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO221PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT60013OtherBLUECROSS BLUESHIELD
MT3400391Medicaid
MT60013OtherBLUECROSS BLUESHIELD