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General NPI Number Information
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NPI Number | 1366426991
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Entity Type | Organization
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Legal Business Name | FREEDOM PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 715 KENSINGTON AVE STE 18
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City | MISSOULA
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State | MT
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Zip | 59801-5769
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Country | US
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Telephone | 406-542-3600
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Fax | 406-542-3672
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Provider Business Mailing Address
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Address Line | 715 KENSINGTON AVE STE 18
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City | MISSOULA
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State | MT
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Zip | 59801-5769
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Country | US
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Telephone | 406-542-3600
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Fax | 406-542-3672
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | KRISTEN RAE WOOD
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Credential | P.T.
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Telephone | 406-542-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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