Individual
MARY MICHELLE O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3627 S 7TH ST W, MISSOULA, MT 59804-1919
(406) 543-5723
(406) 543-5723
Mailing address
3627 S 7TH ST W, MISSOULA, MT 59804-1919
(406) 543-5723
(406) 543-5723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
458
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3401751
—
MT
05
—
601749
—
MT
01
—
61251
BCBS
MT
Enumeration date
07/03/2006
Last updated
07/09/2007
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