MEDICARE: ASHLEY BENDER PT, DPT

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	PTP-PT-LIC-7581	MT

General Provider Information

NPI Number	:	1205236957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY BENDER PT, DPT

Provider Business Mailing Address
First Line	:	1555 TAMARACK LN
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-8812
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 CLAREMONT ST
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-3551
Country	:	US
Telephone Number	:	402-920-0809
Fax Number	:

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

Provider Enumeration Date	:	08/31/2014
Last Update Date	:	07/04/2024

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