Provider Demographics
NPI:1821704800
Name:SAVANA MELLAND, LLC
Entity Type:Organization
Organization Name:SAVANA MELLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SAVANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-671-2781
Mailing Address - Street 1:4490 ETHAN WAY
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-4596
Mailing Address - Country:US
Mailing Address - Phone:406-671-2781
Mailing Address - Fax:
Practice Address - Street 1:96 LAURA LOUISE LN STE 2
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-5619
Practice Address - Country:US
Practice Address - Phone:406-671-2781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy