MEDICARE: MISS DAWN M NELSON 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	1597PT	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	61488	OTHER	MT	BCBS

General Provider Information

NPI Number	:	1174623979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DAWN M NELSON P.T.

Provider Business Mailing Address
First Line	:	PO BOX 3
Second Line	:
City	:	FORT BENTON
State	:	MT
Zip	:	59442-0003
Country	:	US
Telephone Number	:	406-622-3684
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 SAINT CHARLES ST
Second Line	:
City	:	FORT BENTON
State	:	MT
Zip	:	59442
Country	:	US
Telephone Number	:	406-622-3684
Fax Number	:	406-622-5047

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/14/2023

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