Individual
SHANNON LEUKUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 GRAND DR, BIGFORK, MT 59911-3563
(406) 837-5041
Mailing address
1050 GRAND DR, BIGFORK, MT 59911-3563
(406) 837-5041
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTP-PTA-LIC-9406
MT
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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