Healthcare Provider Details

I. General information

NPI: 1568451151
Provider Name (Legal Business Name): BRIAN J LANGFORD DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3717 EQUESTRIAN LN
BOZEMAN MT
59718-8809
US

IV. Provider business mailing address

3717 EQUESTRIAN LN
BOZEMAN MT
59718-8809
US

V. Phone/Fax

Practice location:
  • Phone: 406-219-2383
  • Fax:
Mailing address:
  • Phone: 406-219-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number7746
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number15140
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: