Organization
MISSOULA PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ILES DPT (OWNER, PHYSICAL THERAPIST)
(605) 670-1985
Entity
Organization
Contact information
Practice address
220 BENTON AVE, MISSOULA, MT 59801-8726
(605) 670-1985
Mailing address
220 BENTON AVE, MISSOULA, MT 59801-8726
(605) 670-1985
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
07/18/2019
Last updated
10/10/2019
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