Healthcare Provider Details
I. General information
NPI: 1730754243
Provider Name (Legal Business Name): CHLOE BROOKE MAHONEY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/26/2021
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3307 GRAND AVE STE 203
BILLINGS MT
59102-6551
US
IV. Provider business mailing address
3307 GRAND AVE STE 203
BILLINGS MT
59102-6551
US
V. Phone/Fax
- Phone: 406-655-9060
- Fax: 406-655-9065
- Phone: 406-655-9060
- Fax: 406-655-9065
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: