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Organization

SPARK PHYSICAL THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT JOHNSON M.P.T. (OWNER)
(989) 860-1543
Entity
Organization

Contact information

Practice address
1428 GRAND AVE, BILLINGS, MT 59102-3104
(989) 860-1543
Mailing address
1428 GRAND AVE, BILLINGS, MT 59102-3104

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7732
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M011006923
PTAN
MT
Enumeration date
05/23/2016
Last updated
05/23/2016
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