Healthcare Provider Details

I. General information

NPI: 1790611481
Provider Name (Legal Business Name): NATHAN MONOHON PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15905 S 46TH ST STE 140
PHOENIX AZ
85048-2206
US

IV. Provider business mailing address

PO BOX 5718
KALISPELL MT
59903-5718
US

V. Phone/Fax

Practice location:
  • Phone: 480-805-8304
  • Fax: 480-805-8304
Mailing address:
  • Phone: 406-756-0134
  • Fax: 406-309-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-034844
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: