Individual
GARY FRANKLIN LUSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT MS ATC CSCS
Contact information
Practice address
1532 ELLIS ST, STE 201, BOZEMAN, MT 59715
(406) 587-4501
(406) 587-3919
Mailing address
1532 ELLIS ST, STE 201, BOZEMAN, MT 59715
(406) 587-4501
(406) 587-3919
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
248PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000060560
BCBS MT
MT
05
—
0340535
—
MT
01
—
M000005858
MEDICARE
MT
01
—
P00347149
RAILROAD MEDICARE
MT
Enumeration date
07/15/2006
Last updated
07/17/2009
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