Individual
JOYCE E DEFREEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
396 DAHYITA WAY, VICTOR, MT 59875-9560
(406) 642-3619
Mailing address
396 DAHYITA WAY, VICTOR, MT 59875-9560
(406) 642-3619
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
631
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345202
—
MT
Enumeration date
02/25/2007
Last updated
07/09/2007
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