Provider Demographics
NPI:1265256374
Name:MONTANA PELVIC HEALTH, LLC
Entity type:Organization
Organization Name:MONTANA PELVIC HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:TENPAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CLT-LANA
Authorized Official - Phone:406-404-8012
Mailing Address - Street 1:91 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3720
Mailing Address - Country:US
Mailing Address - Phone:781-640-2683
Mailing Address - Fax:
Practice Address - Street 1:1087 STONERIDGE DR STE 1
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7057
Practice Address - Country:US
Practice Address - Phone:406-404-8012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty