Doctor Name: | DESIREE VAN BLARICOM |
NPI Number: | 1033112073 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 1821 |
Business Practice Address: | 435 S Crystal St Ste 400 Butte, MT - 597011506 |
Business Phone Number: | 4064963456 |
Business Fax Number: | 4064963457 |
Mailing Address: | 435 S Crystal St, Ste 400 BUTTE |
State: | MT |
Postal Code: | 597011506 |
Phone Number: | 4064963456 |
Fax Number: | 4064963457 |
NPI Enumeration Date: | 05/23/2005 |
NPI Last Update Date: | 09/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1821 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |