Organization
ROOT THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEZIA PETERSON OT (OCCUPATIONAL THERAPIST/OWNER)
(406) 219-5388
Entity
Organization
Contact information
Practice address
2411 W MAIN ST STE 2, BOZEMAN, MT 59718-3815
(406) 404-6147
Mailing address
2411 W MAIN ST STE 2, BOZEMAN, MT 59718-3815
(406) 219-5388
(406) 219-5379
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
12/06/2018
Last updated
04/12/2024
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