Organization
PEDS TELETHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE LAVERDIERE PT (PHYSICAL THERAPIST OWNER)
(406) 813-1150
Entity
Organization
Contact information
Practice address
6062 LOWER MILLER CREEK RD, MISSOULA, MT 59803-9625
(406) 813-1150
Mailing address
6062 LOWER MILLER CREEK RD, MISSOULA, MT 59803-9625
(406) 813-1150
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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