Individual
STEPHANIE RADTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 HERITAGE WAY, KALISPELL, MT 59901-3145
(406) 755-0800
Mailing address
171 HERITAGE WAY, KALISPELL, MT 59901-3145
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTP-OTA-LIC-3329
MT
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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