Organization
MOUNTAIN LAND PERFORMANCE LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ANDERSON PT (PRESIDENT)
(801) 942-3311
Entity
Organization
Contact information
Practice address
2045 BROADWATER AVE, SUITE 3, BILLINGS, MT 59102-4863
(406) 656-0950
(406) 656-0970
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171
(801) 942-3311
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/02/2006
Last updated
08/03/2016
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