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Individual

MRS. JANE E WISSE-GOETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
2517 7TH AVE S, SUITE A-1, GREAT FALLS, MT 59405-3032
(406) 771-0777
(406) 771-0776
Mailing address
2517 7TH AVE S, SUITE A-1, GREAT FALLS, MT 59405-3032
(406) 771-0777
(406) 771-0776

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
207PT
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3400553
MT
01
P00096023
RAILROAD MEDICARE
MT
Enumeration date
01/11/2007
Last updated
07/08/2007
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