Provider Demographics
NPI:1811544109
Name:RICE, MICHAEL RAY (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAY
Last Name:RICE
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:PO BOX 5718
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-5718
Mailing Address - Country:US
Mailing Address - Phone:406-756-0134
Mailing Address - Fax:406-309-2579
Practice Address - Street 1:3900 S WADSWORTH BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2203
Practice Address - Country:US
Practice Address - Phone:720-510-9092
Practice Address - Fax:720-458-0719
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist