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NPI Code Detail

MEDICARE: CORE PHYSICAL THERAPY LLC

MEDICARE: CORE PHYSICAL THERAPY LLC
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
1261QP2000XPhysical Therapy Clinic/Center
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1730912684
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORE PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 1077 WHITEFISH STAGE
Second Line :
City : KALISPELL
State : MT
Zip : 59901-2735
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1077 WHITEFISH STAGE
Second Line :
City : KALISPELL
State : MT
Zip : 59901-2735
Country : US
Telephone Number : 406-270-2225
Fax Number :
Authorized Official
Title or Position : OWNER, PHYSICAL THERAPIST
Name : KRISTIN STOCKHAM-BALLER
Credential :
Telephone Number : 406-270-2225
Provider Enumeration Date : 08/24/2024
Last Update Date : 06/10/2026

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Directions to “CORE PHYSICAL THERAPY LLC ” Practice Location

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