Organization
FALLON MEDICAL COMPLEX, INC
Active
Other names
Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
SELENA R NELSON (CFO)
(406) 778-5103
Entity
Organization
Contact information
Practice address
202 SOUTH 4TH STREET WEST, BAKER, MT 59313-0820
(406) 778-5103
(406) 778-5155
Mailing address
PO BOX 820, BAKER, MT 59313-0820
(406) 778-5103
(406) 778-5155
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3400816
—
MT
01
—
60093
BCBS PHYSICAL THERAPY
MT
Enumeration date
12/29/2006
Last updated
08/22/2020
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