Healthcare Provider Details

I. General information

NPI: 1689764649
Provider Name (Legal Business Name): BETH ANNE SALUSSO D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3718 E LAKE DR SUITE A
BUTTE MT
59701-4314
US

IV. Provider business mailing address

400 GREY GHOST PT
BUTTE MT
59701-9689
US

V. Phone/Fax

Practice location:
  • Phone: 406-494-7050
  • Fax: 406-494-1424
Mailing address:
  • Phone: 406-491-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2007
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: