1841322310 NPI number — YELLOWSTONE PHYSICAL THERAPY INC.

Table of content: (NPI 1841322310)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841322310 NPI number — YELLOWSTONE PHYSICAL THERAPY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YELLOWSTONE PHYSICAL THERAPY INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841322310
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 US HWY 10 W
Provider Second Line Business Mailing Address:
UNIT E
Provider Business Mailing Address City Name:
LIVINGSTON
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-222-5519
Provider Business Mailing Address Fax Number:
406-222-0366

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 US HWY 10 W
Provider Second Line Business Practice Location Address:
UNIT E
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-222-5519
Provider Business Practice Location Address Fax Number:
406-222-0366
Provider Enumeration Date:
03/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHRETENTHALER
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
JOANN
Authorized Official Title or Position:
BUSINESS OWNER, CORPORATE PRESIDENT
Authorized Official Telephone Number:
406-222-5519

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  198 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CG5577 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: MSF 1117466 . This is a "STATE FUND WORKER'S COMP" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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