Healthcare Provider Details

I. General information

NPI: 1326064916
Provider Name (Legal Business Name): ADVANCED PERFORMANCE & REHABILITATION SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 ELLIS STREET STE 201
BOZEMAN MT
59715
US

IV. Provider business mailing address

1532 ELLIS ST STE 201
BOZEMAN MT
59715-8809
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-4501
  • Fax: 406-587-3919
Mailing address:
  • Phone: 406-587-4501
  • Fax: 406-587-3919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIM KELLY
Title or Position: OFFICE MANAGER
Credential:
Phone: 406-587-4501