MEDICARE: DANIEL JOHN SEBASTIAN P.T.

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	1676	MT

General Provider Information

NPI Number	:	1699988121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL JOHN SEBASTIAN P.T.

Provider Business Mailing Address
First Line	:	3307 GRAND AVE
Second Line	:	SUITE 203
City	:	BILLINGS
State	:	MT
Zip	:	59102-6546
Country	:	US
Telephone Number	:	406-655-9060
Fax Number	:	406-655-9065

Provider Business Practice Location Address
First Line	:	3307 GRAND AVE
Second Line	:	SUITE 203
City	:	BILLINGS
State	:	MT
Zip	:	59102-6546
Country	:	US
Telephone Number	:	406-655-9060
Fax Number	:	406-655-9065

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	11/12/2009

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