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Organization

ZACHARY PORTER LASALLE

Active
Other names
LaSalle Physical Therapy LLC
Organization subpart
No

Provider details

NPI number
Authorized official
ZACHARY PORTER LASALLE PT (PHYSICAL THERAPIST)
(406) 471-2022
Entity
Organization

Contact information

Practice address
734 9TH ST W STE 12, COLUMBIA FALLS, MT 59912-3858
(406) 471-2022
Mailing address
734 9TH ST W STE 12, COLUMBIA FALLS, MT 59912-3858
(406) 471-2022

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1868PT
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M011000799
PTAN
MT
Enumeration date
08/19/2010
Last updated
11/22/2011
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