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NPI Code Detail

MEDICARE: ELISA K MOHR PT

MEDICARE:   ELISA K MOHR  PT
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 Therapist15027MT
2225100000XPhysical Therapist11-05976KS

General Provider Information

NPI Number : 1902391089
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISA K MOHR PT
Provider Business Mailing Address
First Line : 100 WESTVIEW PARK PL
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3074
Country : US
Telephone Number : 406-393-2474
Fax Number :
Provider Business Practice Location Address
First Line : 100 WESTVIEW PARK PL
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3074
Country : US
Telephone Number : 406-393-2474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2018
Last Update Date : 12/16/2019

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Directions to “ ELISA K MOHR PT” Practice Location

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