Healthcare Provider Details

I. General information

NPI: 1346407830
Provider Name (Legal Business Name): ELKHORN HEALTH AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 HIGHWAY 282
CLANCY MT
59634-9519
US

IV. Provider business mailing address

474 HIGHWAY 282
CLANCY MT
59634-9519
US

V. Phone/Fax

Practice location:
  • Phone: 406-933-8311
  • Fax: 406-933-8391
Mailing address:
  • Phone: 406-933-8311
  • Fax: 406-933-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1828
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. DULCINEA A VOERMANS
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 406-933-8311