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NPI Code Detail

MEDICARE: MRS. JAIME PETRO DPT

MEDICARE: MRS. JAIME PETRO DPT
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
12251P0200XPediatric Physical Therapist19420MT

General Provider Information

NPI Number : 1689112443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAIME PETRO DPT
Provider Business Mailing Address
First Line : 500 12TH AVE W STE 2A
Second Line :
City : COLUMBIA FALLS
State : MT
Zip : 59912-3855
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 55 HERITAGE WAY
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3100
Country : US
Telephone Number : 406-471-1117
Fax Number : 406-309-2076
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2017
Last Update Date : 06/01/2026

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Directions to “ MRS. JAIME PETRO DPT” Practice Location

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