Organization Name: | BIGFORK PHYSICAL THERAPY & SPORTS REHABILITATION INC |
NPI Number: | 1649277799 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL JON CLOSE (OWNER PHYSICAL THERAPIST) |
Mailing Address: | 6400 Mt Hwy 35 Bigfork |
State: | MT US |
Postal Code: | 59911 |
Phone Number: | 4068376892 |
Fax Number: | 4068376435 |
NPI Enumeration Date: | 07/05/2005 |
NPI Last Update Date: | 10/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 1350PT |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |