MEDICARE: MARILEE WOYTH

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	225200000X	Physical Therapy Assistant	2264	MT

General Provider Information

NPI Number	:	1992076939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILEE WOYTH

Provider Business Mailing Address
First Line	:	2321 15TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-5009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 15TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-5009
Country	:	US
Telephone Number	:	406-455-5000
Fax Number	:

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

Provider Enumeration Date	:	01/23/2012
Last Update Date	:	01/23/2012

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Directions to “ MARILEE WOYTH ” Practice Location

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