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General NPI Number Information
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NPI Number | 1912977422
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Entity Type | Individual
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Provider Name | DONNA MARY ALINE PT
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 2442 WINNE AVE
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City | HELENA
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State | MT
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Zip | 59601-4915
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Country | US
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Telephone | 406-449-7887
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Fax | 406-449-7888
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Provider Business Mailing Address
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Address Line | 29 PINE RIDGE CIR
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City | CLANCY
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State | MT
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Zip | 59634-9760
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Country | US
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Telephone | 406-933-5969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 130
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License Number State | MT
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