MEDICARE: ALYSON FREITAG 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

General Provider Information

NPI Number	:	1730755414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON FREITAG DPT

Provider Business Mailing Address
First Line	:	25 HERITAGE WAY
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-3100
Country	:	US
Telephone Number	:	406-407-7990
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 12TH AVE W STE 2F
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-3818
Country	:	US
Telephone Number	:	406-892-0681
Fax Number	:

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

Provider Enumeration Date	:	06/02/2021
Last Update Date	:	08/11/2022

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Directions to “ ALYSON FREITAG DPT” Practice Location

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