Healthcare Provider Details

I. General information

NPI: 1235389909
Provider Name (Legal Business Name): PLAINS PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S HUBBARD
PLAINS MT
59859-0190
US

IV. Provider business mailing address

PO BOX 190
PLAINS MT
59859-0190
US

V. Phone/Fax

Practice location:
  • Phone: 406-826-4383
  • Fax: 406-826-4384
Mailing address:
  • Phone: 406-826-4383
  • Fax: 406-826-4384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number3137838
License Number StateMT

VIII. Authorized Official

Name: EMILY C HERNDON
Title or Position: PRESIDENT
Credential: DPT
Phone: 406-826-4383