Healthcare Provider Details

I. General information

NPI: 1114837812
Provider Name (Legal Business Name): JUSTISE BIRKENBUEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 BENEFIS CT
GREAT FALLS MT
59405-4320
US

IV. Provider business mailing address

1800 BENEFIS CT
GREAT FALLS MT
59405-4320
US

V. Phone/Fax

Practice location:
  • Phone: 406-604-4369
  • Fax:
Mailing address:
  • Phone: 406-604-4369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: