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General NPI Number Information
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NPI Number | 1982137121
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Entity Type | Individual
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Provider Name | MICHELLE RENEE CARLILE DPT
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Gender | Female
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 1925 GRAND AVE STE 129
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City | BILLINGS
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State | MT
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Zip | 59102-2776
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Country | US
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Telephone | 406-545-2535
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Fax | 406-412-0537
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Provider Business Mailing Address
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Address Line | 1925 GRAND AVE STE 129 PMB 147699
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City | BILLINGS
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State | MT
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Zip | 59102-2776
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Country | US
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Telephone | 406-545-2535
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Fax | 406-412-0537
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 17155
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License Number State | MT
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