Organization
ORTHOPEDIC REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK A GULICK PT (OWNER)
(406) 407-7990
Entity
Organization
Contact information
Practice address
25 HERITAGE WAY, KALISPELL, MT 59901-3100
(406) 407-7990
(406) 260-4084
Mailing address
25 HERITAGE WAY, KALISPELL, MT 59901-3100
(406) 407-7990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008047
BCBS
MT
01
—
184869400
OWCP FEDERAL WIC
—
01
—
CG8861
RR MEDICARE
MT
Enumeration date
11/09/2006
Last updated
10/28/2024
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