MEDICARE: KIRSTEN J MCCRUMB 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		MT

General Provider Information

NPI Number	:	1669838702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN J MCCRUMB DPT

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	:

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

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	12/12/2023

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