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Organization

CORVALLIS PHYSICAL THERAPY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS J MARTIN MPT (PRESIDENT)
(406) 375-0980
Entity
Organization

Contact information

Practice address
1050 EASTSIDE HWY, CORVALLIS, MT 59828
(406) 961-3914
(406) 363-5271
Mailing address
336 FAIRGROUNDS RD, HAMILTON, MT 59840
(406) 375-0980
(406) 375-9938

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M011001245
MEDICARE B PIN
MT
Enumeration date
06/10/2011
Last updated
09/26/2014
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