MEDICARE: LARRY R PLANT PT

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	571	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

General Provider Information

NPI Number	:	1629027065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY R PLANT PT

Provider Business Mailing Address
First Line	:	1219 TULIP LN
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-3048
Country	:	US
Telephone Number	:	406-240-2172
Fax Number	:	406-728-8260

Provider Business Practice Location Address
First Line	:	1219 TULIP LANE
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802
Country	:	US
Telephone Number	:	406-728-8260
Fax Number	:	406-728-8260

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	01/07/2008

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Directions to “ LARRY R PLANT PT” Practice Location

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