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Individual provider · Physical Therapist · Whitefish, MT

NPI

1912486358

Type

Individual (Type 1)

Primary specialty

Physical Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225100000X

License number

PTP-PT-LIC-15069 (MT)

Sex

Male

Sole proprietor

No

Enumerated

2018-08-07

Last updated

2026-05-14