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General NPI Number Information
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NPI Number | 1215479472
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Entity Type | Organization
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Legal Business Name | TROTTING HORSE THERAPEUTIC RIDING
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 1270 TROTTING HORSE LN
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City | MISSOULA
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State | MT
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Zip | 59804-9770
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Country | US
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Telephone | 406-370-8477
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Fax |
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Provider Business Mailing Address
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Address Line | 1270 TROTTING HORSE LN
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City | MISSOULA
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State | MT
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Zip | 59804-9770
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Country | US
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Telephone | 406-370-8477
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Fax |
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Authorized Official
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Title or Position | BOARD OF DIRECTORS
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Name | MRS. AMANDA DARROW
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Credential |
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Telephone | 406-880-3417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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