Healthcare Provider Details

I. General information

NPI: 1912290206
Provider Name (Legal Business Name): KACI LEE MONROE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KACI LEE CALAWAY PT, DPT, CERT DN, CE

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HOLT DRIVE
BIGFORK MT
59911
US

IV. Provider business mailing address

P.O. BOX 1557
BIGFORK MT
59911
US

V. Phone/Fax

Practice location:
  • Phone: 406-837-3255
  • Fax: 406-837-3256
Mailing address:
  • Phone: 406-837-3255
  • Fax: 406-837-3256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2406
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: