Organization
LONE PEAK PHYSICAL THERAPY, INC
Active
Parent organization
LONE PEAK PHYSICAL THERAPY, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONE PEAK PHYSICAL THERAPY, INC
Authorized official
JOHN C BOERSMA MPT, OCS (OWNER/PRESIDENT)
(406) 522-7488
Entity
Organization
Contact information
Practice address
3745 HARRISON AVE STE C, BUTTE, MT 59701-6814
(406) 494-7050
(406) 494-1424
Mailing address
PO BOX 11629, BOZEMAN, MT 59719-1629
(406) 522-7488
(406) 522-7487
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477678969
—
MT
Enumeration date
06/09/2017
Last updated
03/20/2019
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