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Organization

LONE PEAK PHYSICAL THERAPY, INC.

Active
Parent organization
LONE PEAK PHYSICAL THERAPY INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
LONE PEAK PHYSICAL THERAPY INC.
Authorized official
JOHN C BOERSMA MPT, OCS (OWNER/PRESIDENT)
(406) 522-7488
Entity
Organization

Contact information

Practice address
312 W MAIN ST STE 1, BELGRADE, MT 59714-3836
(406) 388-2235
(406) 388-2281
Mailing address
PO BOX 11629, BOZEMAN, MT 59719-1629
(406) 522-7488
(406) 522-7487

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
MT
225X00000X
Occupational Therapist
MT
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1477678969
MT
Enumeration date
12/18/2016
Last updated
03/20/2019
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