Individual
JASON RICO PERIGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1221 DURSTON RD W, BOZEMAN, MT 59715
(406) 582-3300
Mailing address
1020 N YELLOWSTONE AVE, BOZEMAN, MT 59718
(406) 587-9598
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1536
MT
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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