Individual
ANDREA DIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
336 FAIRGROUNDS RD, HAMILTON, MT 59840-3126
(406) 375-0980
(406) 375-9938
Mailing address
336 FAIRGROUNDS RD, HAMILTON, MT 59840-3126
(406) 375-0980
(406) 375-9938
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTP-PTA-LIC-7496
MT
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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