Healthcare Provider Details

I. General information

NPI: 1104742295
Provider Name (Legal Business Name): TAMI LEIGH ELLIS DPT, BSCPT, BPE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7935, HIGHWAY 35 SUITE 206
BIGFORK MT
59911
US

IV. Provider business mailing address

573 CLOUD CREEK RD
SOMERS MT
59932-9630
US

V. Phone/Fax

Practice location:
  • Phone: 406-871-1751
  • Fax:
Mailing address:
  • Phone: 406-871-1751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31652
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: