Healthcare Provider Details

I. General information

NPI: 1629405261
Provider Name (Legal Business Name): MICHAEL JASON GARRE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 CENTENNIAL DR STE 101
LIVINGSTON MT
59047-8101
US

IV. Provider business mailing address

606 W MAIN ST
BOZEMAN MT
59715-3469
US

V. Phone/Fax

Practice location:
  • Phone: 406-222-5519
  • Fax: 406-222-0366
Mailing address:
  • Phone: 406-599-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTP-PT-LIC-5940
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: