Healthcare Provider Details

I. General information

NPI: 1285289231
Provider Name (Legal Business Name): CUTTING EDGE ORTHOPEDIC PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 ECHELON PL STE A
HELENA MT
59602-7695
US

IV. Provider business mailing address

370 GRIZZ AVE APT C
HELENA MT
59602-7489
US

V. Phone/Fax

Practice location:
  • Phone: 406-459-3903
  • Fax: 406-646-3025
Mailing address:
  • Phone: 406-459-3903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DUSTIN B. BUCK
Title or Position: OWNER
Credential: PT
Phone: 406-459-3903