Individual
ELIZABETH BLUE DEATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 N TRACY AVE, BOZEMAN, MT 59715-3564
(406) 587-8710
Mailing address
408 W MENDENHALL ST, BOZEMAN, MT 59715-3449
(419) 618-3274
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2375PTA
MT
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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