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Individual

ERIC DEAN DESETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT/RL

Contact information

Practice address
2909 WILSON ST, MILES CITY, MT 59301-5722
(406) 234-3373
(406) 234-3374
Mailing address
2909 WILSON ST, MILES CITY, MT 59301-5722
(406) 234-3373
(406) 234-3374

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTP-OT-LIC-478
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1801816640
MT
01
1841474087
RAILROAD MEDICARE
MT
Enumeration date
07/21/2006
Last updated
05/06/2025
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