Healthcare Provider Details

I. General information

NPI: 1801934211
Provider Name (Legal Business Name): ALTA PHYSICAL THERAPY & FITNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4739 MEADOW LN
BOZEMAN MT
59715-9631
US

IV. Provider business mailing address

4739 MEADOW LN
BOZEMAN MT
59715-9631
US

V. Phone/Fax

Practice location:
  • Phone: 406-586-2686
  • Fax: 406-586-2686
Mailing address:
  • Phone: 406-586-2686
  • Fax: 406-586-2686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELE M SIMARD
Title or Position: PRESIDENT/ PT
Credential:
Phone: 406-220-0307