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
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