| Organization Name: | K4JPC |
| NPI Number: | 1538348545 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHAWN GREEN (BUSINESS MANAGER) |
| Mailing Address: | 2517 7th Ave S Suite A-1 Great Falls |
| State: | MT US |
| Postal Code: | 594053032 |
| Phone Number: | 4067710777 |
| Fax Number: | 4067710776 |
| NPI Enumeration Date: | 10/25/2007 |
| NPI Last Update Date: | 10/25/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 591 |
| 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 |