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NPI Code Detail

MEDICARE: STACY PADDEN

MEDICARE: STACY PADDEN
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
1225100000XPhysical Therapist414MT

General Provider Information

NPI Number : 1801172762
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY PADDEN
Provider Business Mailing Address
First Line : 1233 N 30TH ST
Second Line :
City : BILLINGS
State : MT
Zip : 59101-0127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1035 1ST AVE
Second Line :
City : LAUREL
State : MT
Zip : 59044-2119
Country : US
Telephone Number : 406-628-2831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2011
Last Update Date : 10/24/2011

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Directions to “ STACY PADDEN ” Practice Location

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