Organization
PERFORMANCE PHYSICAL THERAPY, PC
Active
Organization
PERFORMANCE PHYSICAL THERAPY, PC
Active
Other names
Premier Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC SHANE SPEARS MPT (PRESIDENT PHYSICAL THERAPIST)
(406) 846-7770
Entity
Organization
Contact information
Practice address
600 MAIN ST, DEER LODGE, MT 59722-1440
(406) 846-7770
(406) 846-7771
Mailing address
825 SAGEBRUSH LN STE 1, DEER LODGE, MT 59722-2320
(406) 846-7770
(406) 846-7771
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060833
BCBS
MT
Enumeration date
06/06/2006
Last updated
08/16/2019
Update your record
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