Individual
HENRY GAUDION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3985 VALLEY COMMONS DR, BOZEMAN, MT 59718-6633
(406) 585-4642
(406) 585-2878
Mailing address
3985 VALLEY COMMONS DR, BOZEMAN, MT 59718-6633
(207) 518-3573
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTP-PTA-LIC-21651
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTP-PTA-LIC-21651
PTA LICENSE
MT
Enumeration date
06/28/2021
Last updated
06/28/2021
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