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NPI Code Detail

MEDICARE: AMANDA LORENE BENDER OTC

MEDICARE: AMANDA LORENE BENDER OTC
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
1225200000XPhysical Therapy Assistant2022MT

General Provider Information

NPI Number : 1992971881
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LORENE BENDER OTC
Provider Business Mailing Address
First Line : 9 14TH AVE W
Second Line :
City : POLSON
State : MT
Zip : 59860-5321
Country : US
Telephone Number : 406-883-4378
Fax Number : 406-883-0039
Provider Business Practice Location Address
First Line : 9 14TH AVE W
Second Line :
City : POLSON
State : MT
Zip : 59860-5321
Country : US
Telephone Number : 406-883-4378
Fax Number : 406-883-0039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2008
Last Update Date : 05/01/2008

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Directions to “ AMANDA LORENE BENDER OTC” Practice Location

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