Organization
SHANNON SEPULVEDA, DPT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON SEPULVEDA (MEMBER)
(631) 434-5274
Entity
Organization
Contact information
Practice address
115 W KAGY BLVD STE D, BOZEMAN, MT 59715-6043
(631) 434-5274
(406) 272-3404
Mailing address
415 HENDERSON ST, BOZEMAN, MT 59715-7103
(631) 434-5274
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2409
MT
Other
Enumeration date
08/02/2017
Last updated
11/24/2021
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