Individual
MR. MARK ERIC ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
600 W 21ST STREET, RED LODGE, MT 59068
(406) 446-1112
Mailing address
PO BOX 590, RED LODGE, MT 59068-0590
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1696
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10573
HOSPITAL #
MT
Enumeration date
03/08/2007
Last updated
07/08/2007
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