Provider Demographics
NPI:1760675664
Name:FREESTONE REHABILITATION, INC
Entity Type:Organization
Organization Name:FREESTONE REHABILITATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:NAPRSTEK
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:406-586-5694
Mailing Address - Street 1:1532 ELLIS ST STE 103
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8809
Mailing Address - Country:US
Mailing Address - Phone:406-586-5694
Mailing Address - Fax:406-586-5694
Practice Address - Street 1:1532 ELLIS ST STE 103
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8809
Practice Address - Country:US
Practice Address - Phone:406-586-5694
Practice Address - Fax:406-586-5694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT727332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT5331230001Medicare NSC
MT000084497Medicare PIN