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General NPI Number Information
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NPI Number | 1710239207
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Entity Type | Organization
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Legal Business Name | BEST LIFE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 2420 PINE BUTTE DR
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City | COLSTRIP
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State | MT
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Zip | 59323
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Country | US
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Telephone | 406-477-3344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2114
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City | COLSTRIP
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State | MT
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Zip | 59323-2114
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Country | US
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Telephone | 406-477-3344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER D ALLIES
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Credential | PT, DPT
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Telephone | 406-477-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1646
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License Number State | MT
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