Healthcare Provider Details

I. General information

NPI: 1356530836
Provider Name (Legal Business Name): THS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 AMERICAN WAY
MISSOULA MT
59808-1379
US

IV. Provider business mailing address

3620 AMERICAN WAY
MISSOULA MT
59808-1379
US

V. Phone/Fax

Practice location:
  • Phone: 406-543-2326
  • Fax: 406-543-2327
Mailing address:
  • Phone: 406-543-2326
  • Fax: 406-543-2327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1359PT
License Number StateMT

VIII. Authorized Official

Name: MR. MARK A DUNIFER
Title or Position: PRESIDENT
Credential: PT
Phone: 406-543-2326