Healthcare Provider Details

I. General information

NPI: 1982913810
Provider Name (Legal Business Name): PHYSICAL THERAPY SPECIALISTS OF FLORENCE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 RODEO DR
FLORENCE MT
59833-6859
US

IV. Provider business mailing address

293 RODEO DR
FLORENCE MT
59833-6859
US

V. Phone/Fax

Practice location:
  • Phone: 406-273-9033
  • Fax: 406-273-0993
Mailing address:
  • Phone: 406-273-9033
  • Fax: 406-273-0993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DOUGLAS J MARTIN
Title or Position: PRESIDENT
Credential: MPT
Phone: 406-375-0980