Individual
LYNNELL MARIE GRAVELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
175 COMMONS LOOP STE 100, KALISPELL, MT 59901-1904
(406) 261-8311
Mailing address
175 COMMONS LOOP, STE 100, KALISPELL, MT 59901-1904
(406) 261-8311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1315
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3400102
—
MT
Enumeration date
10/17/2006
Last updated
08/27/2019
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