Provider Demographics
NPI:1942327051
Name:NORTHERN PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:NORTHERN PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:BESTWICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:406-862-7997
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty