Organization
GLACIER FUNCTIONAL THERAPY
Active
Other names
Northern Lights Functional Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
SELENA RUYI BACH OTR/L (SOLE MEMBER)
(208) 610-8671
Entity
Organization
Contact information
Practice address
903 SPOKANE AVE STE 4, WHITEFISH, MT 59937-2980
(406) 282-4064
Mailing address
PO BOX 1087, WHITEFISH, MT 59937-1087
(208) 610-8671
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/26/2025
Last updated
03/27/2025
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