Healthcare Provider Details

I. General information

NPI: 1518892439
Provider Name (Legal Business Name): SWAN RIVER PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 BOAT CLUB DR
BIGFORK MT
59911-3128
US

IV. Provider business mailing address

PO BOX 942
BIGFORK MT
59911-0942
US

V. Phone/Fax

Practice location:
  • Phone: 406-407-8799
  • Fax:
Mailing address:
  • Phone: 406-407-8799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: STARR EKO BROWN
Title or Position: MEMBER/MANAGER
Credential: PT
Phone: 406-407-8799