Provider Demographics
NPI:1689764649
Name:SALUSSO, BETH ANNE (DPT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:SALUSSO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 GREY GHOST PT
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-9689
Mailing Address - Country:US
Mailing Address - Phone:406-491-3931
Mailing Address - Fax:
Practice Address - Street 1:3718 E LAKE DR
Practice Address - Street 2:SUITE A
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4314
Practice Address - Country:US
Practice Address - Phone:406-494-7050
Practice Address - Fax:406-494-1424
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist