| Organization Name: | LONE PEAK PHYSICAL THERAPY, INC. |
| NPI Number: | 1619305752 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMEY KABISCH (CFO) |
| Mailing Address: | 536 S Cottonwood Rd Suite 103 Bozeman |
| State: | MT US |
| Postal Code: | 597189515 |
| Phone Number: | 4065486266 |
| Fax Number: | 4065486269 |
| NPI Enumeration Date: | 10/29/2013 |
| NPI Last Update Date: | 10/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PTPPTLIC1729 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |