| Organization Name: | ZACHARY PORTER LASALLE |
| NPI Number: | 1629384367 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ZACHARY PORTER LASALLE (PHYSICAL THERAPIST) |
| Mailing Address: | 734 9th St W Ste 12 Columbia Falls |
| State: | MT US |
| Postal Code: | 599123858 |
| Phone Number: | 4064712022 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2010 |
| NPI Last Update Date: | 11/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 1868PT |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |