Provider Demographics
NPI:1396568549
Name:PERRY, JUSTIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 MOUNTAIN VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:CUT BANK
Mailing Address - State:MT
Mailing Address - Zip Code:59427-3627
Mailing Address - Country:US
Mailing Address - Phone:406-873-3679
Mailing Address - Fax:
Practice Address - Street 1:802 2ND ST SE
Practice Address - Street 2:
Practice Address - City:CUT BANK
Practice Address - State:MT
Practice Address - Zip Code:59427-3329
Practice Address - Country:US
Practice Address - Phone:406-873-3679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist