Organization
MONTANA PLAINS REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL JOHN TACKE MD (PRESIDENT)
(406) 455-2140
Entity
Organization
Contact information
Practice address
500 15TH AVE S, SUITE ONE, GREAT FALLS, MT 59405-4304
(406) 455-2149
(406) 455-2141
Mailing address
500 15TH AVE S, SUITE ONE, GREAT FALLS, MT 59405-4304
(406) 455-2140
(406) 455-2141
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01336
RR MEDICARE
—
Enumeration date
12/27/2005
Last updated
09/13/2013
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