MEDICARE: MRS. TANA LEE CROMWELL P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1544	MT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	650020028	OTHER	MT	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0157386	OTHER	MT	WAWC
3	1164493227	OTHER	MT	MT HEALTHCARE
4	000061936	OTHER	MT	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MSF1128515	OTHER	MT	MT STATE FUND
7	841391220011	OTHER	MT	EBMS

General Provider Information

NPI Number	:	1164493227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANA LEE CROMWELL P.T.

Provider Business Mailing Address
First Line	:	3782 E RIGGS ST
Second Line	:
City	:	EAST HELENA
State	:	MT
Zip	:	59635-3377
Country	:	US
Telephone Number	:	406-227-1593
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 N MONTANA AVE STE D
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59602-7804
Country	:	US
Telephone Number	:	406-502-1782
Fax Number	:	406-502-1783

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	12/28/2024

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Directions to “ MRS. TANA LEE CROMWELL P.T.” Practice Location

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