Provider Demographics
NPI:1023417268
Name:BARTLETT, MAXWELL A (DPT)
Entity type:Individual
Prefix:
First Name:MAXWELL
Middle Name:A
Last Name:BARTLETT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 767
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834
Mailing Address - Country:US
Mailing Address - Phone:406-626-0026
Mailing Address - Fax:406-626-1780
Practice Address - Street 1:16400 FRENCHTOWN FRONTAGE ROAD
Practice Address - Street 2:
Practice Address - City:FRENCHTOWN
Practice Address - State:MT
Practice Address - Zip Code:59834
Practice Address - Country:US
Practice Address - Phone:406-626-0026
Practice Address - Fax:406-626-1780
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist