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General NPI Number Information
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NPI Number | 1861942518
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Entity Type | Organization
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Legal Business Name | SAPPHIRE PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 1705 BOW ST
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City | MISSOULA
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State | MT
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Zip | 59801-5652
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Country | US
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Telephone | 406-549-5283
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Fax | 406-549-5392
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Provider Business Mailing Address
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Address Line | 1705 BOW ST
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City | MISSOULA
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State | MT
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Zip | 59801-5652
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN FIORE
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Credential | PT
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Telephone | 406-549-5283
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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 | 11125
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License Number State | MT
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