MEDICARE: SWAN RIVER PHYSICAL THERAPY LLC

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

General Provider Information

NPI Number	:	1518892439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWAN RIVER PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	PO BOX 942
Second Line	:
City	:	BIGFORK
State	:	MT
Zip	:	59911-0942
Country	:	US
Telephone Number	:	406-407-8799
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 BOAT CLUB DR
Second Line	:
City	:	BIGFORK
State	:	MT
Zip	:	59911-3128
Country	:	US
Telephone Number	:	406-407-8799
Fax Number	:

Authorized Official
Title or Position	:	MEMBER/MANAGER
Name	:	STARR EKO BROWN
Credential	:	PT
Telephone Number	:	406-407-8799

Provider Enumeration Date	:	06/13/2026
Last Update Date	:	06/13/2026

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