Provider Demographics
NPI:1982226650
Name:MOUNTAIN PHYSICAL THERAPY AND FITNESS CENTER LLC
Entity Type:Organization
Organization Name:MOUNTAIN PHYSICAL THERAPY AND FITNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:SIMMONS
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-257-0933
Mailing Address - Street 1:2593 HIGHWAY 2 EAST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-257-0933
Mailing Address - Fax:406-257-3426
Practice Address - Street 1:2593 HIGHWAY 2 EAST
Practice Address - Street 2:SUITE 6
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:406-257-0933
Practice Address - Fax:406-257-3426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty