Healthcare Provider Details

I. General information

NPI: 1730452798
Provider Name (Legal Business Name): ROBERT PICARD ATC, PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 25TH ST S THERAPY CENTER
GREAT FALLS MT
59405-5183
US

IV. Provider business mailing address

1401 25TH ST S THERAPY CENTER
GREAT FALLS MT
59405-5183
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-8930
  • Fax:
Mailing address:
  • Phone: 406-731-8930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2454
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number22
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: