Organization
LONE PEAK PHYSICAL THERAPY INC
Active
Parent organization
LONE PEAK PHYSICAL THERAPY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONE PEAK PHYSICAL THERAPY INC
Authorized official
JOHN C BOERSMA MPT (OWNER)
(406) 995-7525
Entity
Organization
Contact information
Practice address
334 TOWN CENTER AVE, BIG SKY, MT 59716
(406) 995-7525
(406) 995-7528
Mailing address
PO BOX 11629, BOZEMAN, MT 59719-1629
(406) 522-7488
(406) 522-7487
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477678969
—
MT
Enumeration date
01/23/2007
Last updated
03/21/2019
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