Healthcare Provider Details

I. General information

NPI: 1457327769
Provider Name (Legal Business Name): LOGAN HEALTH - WHITEFISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HOSPITAL WAY
WHITEFISH MT
59937
US

IV. Provider business mailing address

1600 HOSPITAL WAY
WHITEFISH MT
59937-7849
US

V. Phone/Fax

Practice location:
  • Phone: 406-863-3500
  • Fax:
Mailing address:
  • Phone: 406-863-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10361
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10361
License Number StateMT

VIII. Authorized Official

Name: KEVIN ABEL
Title or Position: CEO
Credential:
Phone: 406-863-3500