Individual
MS. LESLIE M MULLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED OTR, ATP
Contact information
Practice address
MONTECH, 634 EDDY AVE, MISSOULA, MT 59812-0001
(406) 243-5486
(406) 243-4730
Mailing address
506 BONDURANT CT # B, MISSOULA, MT 59801-1401
(406) 549-2010
(406) 243-4730
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
56
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347276
—
MT
01
—
660950
BLUE CROSS BLUE SHIELD MT
MT
Enumeration date
02/06/2007
Last updated
07/08/2007
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