# LONE PEAK PHYSICAL THERAPY, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619305752
- **Authorized official:** JAMEY KABISCH (CFO)
- **Authorized official phone:** (406) 223-0478

## Contact information

- **Practice address:** 630 BOARDWALK AVE STE 1, BOZEMAN, MT 59718-4118
- **Practice address phone:** (406) 548-6266
- **Practice address fax:** (406) 548-6269
- **Mailing address:** 630 BOARDWALK AVE STE 1, BOZEMAN, MT 59718-4118
- **Mailing address phone:** (406) 548-6266
- **Mailing address fax:** (406) 548-6269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PTPPTLIC1729 | MT | — |
| 225X00000X | Occupational Therapist | OTPOTLIC997 | MT | Yes |

## Other

- **Enumeration date:** 10/29/2013
- **Last updated:** 03/20/2019