Healthcare Provider Details

I. General information

NPI: 1205754363
Provider Name (Legal Business Name): ORTHOPEDIC REHAB INC
Entity Type: Organization
Gender:
Sole Proprietor:

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

609 W 8TH ST STE A
LIBBY MT
59923-1829
US

IV. Provider business mailing address

25 HERITAGE WAY
KALISPELL MT
59901-3100
US

V. Phone/Fax

Practice location:
  • Phone: 406-293-8942
  • Fax:
Mailing address:
  • Phone: 406-407-7990
  • Fax: 855-928-0774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: PATRICK A GULICK
Title or Position: MS PT/CO-OWNER
Credential: MS PT
Phone: 406-407-7990