MEDICARE: FRONTIER PHYSICAL THERAPY PC

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
2	225100000X	Physical Therapist	776	MT

General Provider Information

NPI Number	:	1669680088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONTIER PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	203 SMELTER AVE NE STE B
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1924
Country	:	US
Telephone Number	:	406-727-2826
Fax Number	:	406-727-3522

Provider Business Practice Location Address
First Line	:	203 SMELTER AVE NE STE B
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1924
Country	:	US
Telephone Number	:	406-727-2826
Fax Number	:	406-727-3522

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MICHAEL JOHN JENSEN
Credential	:	MPT, OCS
Telephone Number	:	406-727-2826

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	12/12/2023

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