Organization
OPTIMAL SPORTS PHYSICAL THERAPY
Active
Organization
OPTIMAL SPORTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNANNA C SULLIVAN PT, DPT, OCS, SCS, A (OWNER)
(719) 659-6088
Entity
Organization
Contact information
Practice address
3150 N MONTANA AVE STE D, HELENA, MT 59602-7804
(406) 502-1782
(406) 502-1783
Mailing address
1605 KNIGHT ST, HELENA, MT 59601-2355
(719) 659-6088
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTP-PT-LIC-5810
MT
Other
Enumeration date
05/16/2017
Last updated
07/18/2019
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