MEDICARE: GRASSROOTS PHYSICAL THERAPY

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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1831022961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRASSROOTS PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	2011 N 22ND AVE STE 4B
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-2702
Country	:	US
Telephone Number	:	385-226-5481
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 N 22ND AVE STE 4B
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-2702
Country	:	US
Telephone Number	:	385-226-5481
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ESTHER ELLEN SMITH
Credential	:	DPT
Telephone Number	:	385-226-5481

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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