Provider Demographics
NPI:1891221818
Name:BIGHORN PHYSICAL THERAPY AND SPORTS MEDICINE, P.C.
Entity Type:Organization
Organization Name:BIGHORN PHYSICAL THERAPY AND SPORTS MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:REESOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:406-535-6717
Mailing Address - Street 1:120 WUNDERLIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2358
Mailing Address - Country:US
Mailing Address - Phone:406-535-5001
Mailing Address - Fax:
Practice Address - Street 1:120 WUNDERLIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2358
Practice Address - Country:US
Practice Address - Phone:406-535-6717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty