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General NPI Number Information
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NPI Number | 1427209246
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Entity Type | Organization
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Legal Business Name | CANYON FERRY PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 510 N FRONT ST
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City | TOWNSEND
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State | MT
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Zip | 59644-2002
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Country | US
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Telephone | 406-266-9945
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Fax | 406-266-9945
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Provider Business Mailing Address
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Address Line | 510 N FRONT ST
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City | TOWNSEND
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State | MT
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Zip | 59644-2002
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Country | US
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Telephone | 406-266-9945
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Fax | 406-266-9945
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Authorized Official
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Title or Position | PRESIDENT
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Name | WANDA LAMBOTT
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Credential | PT
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Telephone | 406-266-9945
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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 | 1414
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License Number State | MT
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