Organization
MONTANA ATHLETIC CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERT MORAN (OWNER)
(406) 251-2323
Entity
Organization
Contact information
Practice address
5000 BLUE MOUNTAIN RD, MISSOULA, MT 59804-9207
(406) 251-2323
Mailing address
PO BOX 1600, LOLO, MT 59847-1600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
MT
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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