Healthcare Provider Details

I. General information

NPI: 1710239207
Provider Name (Legal Business Name): BEST LIFE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 PINE BUTTE DR
COLSTRIP MT
59323
US

IV. Provider business mailing address

PO BOX 2114
COLSTRIP MT
59323-2114
US

V. Phone/Fax

Practice location:
  • Phone: 406-477-3344
  • Fax:
Mailing address:
  • Phone: 406-477-3344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1646
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER D ALLIES
Title or Position: OWNER
Credential: PT, DPT
Phone: 406-477-3344