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NPI Code Detail

MEDICARE: DR. BRYAN JEFFREY LEEPER D.P.T.

MEDICARE: DR. BRYAN JEFFREY LEEPER D.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
12251X0800XOrthopedic Physical Therapist3591KS
2225100000XPhysical Therapist13017MT

General Provider Information

NPI Number : 1811066087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRYAN JEFFREY LEEPER D.P.T.
Provider Business Mailing Address
First Line : 100 WESTVIEW PARK PL
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 WESTVIEW PARK PL
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3074
Country : US
Telephone Number : 406-393-2473
Fax Number : 406-393-2475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 12/16/2019

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