Individual
MR. MICHAEL N HATTLESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
336 FAIRGROUNDS RD, HAMILTON, MT 59840-3126
(406) 375-0980
(406) 375-9938
Mailing address
336 FAIRGROUNDS RD, HAMILTON, MT 59840-3126
(406) 375-0980
(406) 375-9938
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1990
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3402159
—
MT
01
—
61611
BCBS
MT
01
—
P00326566
RAILROAD MEDICARE
—
Enumeration date
06/07/2006
Last updated
01/17/2008
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