Healthcare Provider Details

I. General information

NPI: 1063330181
Provider Name (Legal Business Name): NICHOLE HAMILTON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HERITAGE WAY
KALISPELL MT
59901-3100
US

IV. Provider business mailing address

25 HERITAGE WAY
KALISPELL MT
59901-3100
US

V. Phone/Fax

Practice location:
  • Phone: 406-407-7990
  • Fax: 855-928-0774
Mailing address:
  • Phone: 406-407-7990
  • Fax: 855-928-0774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPRD-PT-PRV-31729
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: