Healthcare Provider Details

I. General information

NPI: 1780349084
Provider Name (Legal Business Name): LIMBER PINE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2021
Last Update Date: 11/02/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 ARROWLEAF HILLS DR
BOZEMAN MT
59715-9277
US

IV. Provider business mailing address

2375 ARROWLEAF HILLS DR
BOZEMAN MT
59715-9277
US

V. Phone/Fax

Practice location:
  • Phone: 608-695-1019
  • Fax:
Mailing address:
  • Phone: 608-695-1019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ROBERT RITTER JACH
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 608-695-1019