MEDICARE: PAMELA NATION MPT

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	2812	NH

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

General Provider Information

NPI Number	:	1609827492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA NATION MPT

Provider Business Mailing Address
First Line	:	1114 BIG FLAT RD
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59804-9223
Country	:	US
Telephone Number	:	603-848-0006
Fax Number	:

Provider Business Practice Location Address
First Line	:	3802 EASTSIDE HWY
Second Line	:
City	:	STEVENSVILLE
State	:	MT
Zip	:	59870-2224
Country	:	US
Telephone Number	:	406-777-3523
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	04/06/2022

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