Individual
ROGER E TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 W PENNSYLVANIA ST, ANACONDA, MT 59711-1931
(406) 563-8500
(406) 563-8565
Mailing address
401 W PENNSYLVANIA ST, ANACONDA, MT 59711-1931
(406) 563-8500
(406) 563-8565
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1521PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1521PT
STATE LICENSE
MT
Enumeration date
09/10/2008
Last updated
09/10/2008
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