MEDICARE: RYAN CHANG 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	12216	MN

General Provider Information

NPI Number	:	1508434705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN CHANG DPT

Provider Business Mailing Address
First Line	:	PO BOX 11629
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59719-1629
Country	:	US
Telephone Number	:	406-522-7488
Fax Number	:	406-522-7487

Provider Business Practice Location Address
First Line	:	1741 GRAND AVE
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-2937
Country	:	US
Telephone Number	:	406-969-6610
Fax Number	:	406-969-6611

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

Provider Enumeration Date	:	06/14/2021
Last Update Date	:	06/14/2021

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Directions to “ RYAN CHANG DPT” Practice Location

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