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Organization
TRI-STATE PHYSICAL THERAPY SERVICES INC
Active
Organization
TRI-STATE PHYSICAL THERAPY SERVICES INC
Active
Other names
Physical Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BHANU MONTGOMERY PT (PRESIDENT)
(928) 754-0700
Entity
Organization
Contact information
Practice address
1788 HIGHWAY 95, #14, BULLHEAD CITY, AZ 86442-6074
(928) 758-1007
(928) 758-2544
Mailing address
1788 HIGHWAY 95, #14, BULLHEAD CITY, AZ 86442-6074
(928) 758-1007
(928) 758-2544
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z1029
HEALTH NET
AZ
01
—
696683
UNITED HEALTH CARE
AZ
01
—
7880871
AETNA
AZ
05
—
792201
—
AZ
01
—
AZ0463070
BCBS
AZ
01
—
P00154262
RAILROAD MEDICARE
AZ
Enumeration date
10/18/2005
Last updated
04/28/2009
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