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General NPI Number Information
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NPI Number | 1902572472
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Entity Type | Organization
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Legal Business Name | EMPOWER PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 145 RAWLINGS RD
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City | LIBBY
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State | MT
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Zip | 59923-8918
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Country | US
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Telephone | 406-293-7021
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Fax |
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Provider Business Mailing Address
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Address Line | 145 RAWLINGS RD
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City | LIBBY
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State | MT
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Zip | 59923-8918
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Country | US
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Telephone | 406-293-7021
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST / OWNER
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Name | DR. NICHOLAS A PETERSON
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Credential | PT, DPT
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Telephone | 406-293-7021
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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 |
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License Number State |
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