MEDICARE: DONNA LOUISE VINNEDGE P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	262	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326142886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA LOUISE VINNEDGE P.T.

Provider Business Mailing Address
First Line	:	900 2ND ST. S. SUITE 2
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4406
Country	:	US
Telephone Number	:	406-770-3171
Fax Number	:	406-770-3173

Provider Business Practice Location Address
First Line	:	914 13TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4406
Country	:	US
Telephone Number	:	406-770-3171
Fax Number	:	406-770-3173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	07/23/2012

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