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General NPI Number Information
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NPI Number | 1386018869
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Entity Type | Organization
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Legal Business Name | RIPPLES PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 1267 QUARTER HORSE LN
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City | KALISPELL
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State | MT
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Zip | 59901-2514
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Country | US
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Telephone | 406-396-3394
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Fax |
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Provider Business Mailing Address
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Address Line | 1267 QUARTER HORSE LN
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City | KALISPELL
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State | MT
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Zip | 59901-2514
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Country | US
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Telephone | 406-396-3394
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY/OWNER
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Name | DR. KELLY LYNN MACROW
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Credential | DPT, CWS
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Telephone | 406-396-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT-LIC-1936
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License Number State | MT
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