Healthcare Provider Details

I. General information

NPI: 1013910066
Provider Name (Legal Business Name): JOHN FIORE PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 S 3RD ST W
MISSOULA MT
59801-1334
US

IV. Provider business mailing address

1705 BOW ST
MISSOULA MT
59801-5652
US

V. Phone/Fax

Practice location:
  • Phone: 406-549-5283
  • Fax: 406-549-5392
Mailing address:
  • Phone: 406-549-5283
  • Fax: 406-549-5392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number809
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: