Provider Demographics
NPI:1194956995
Name:JOSEPH PURKETT SPEECH THERAPY SERVICES INC
Entity type:Organization
Organization Name:JOSEPH PURKETT SPEECH THERAPY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH/LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PURKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC SLP
Authorized Official - Phone:406-587-1651
Mailing Address - Street 1:PO BOX 6384
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-6384
Mailing Address - Country:US
Mailing Address - Phone:406-587-1651
Mailing Address - Fax:
Practice Address - Street 1:40 GARDNER PARK DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-9229
Practice Address - Country:US
Practice Address - Phone:406-587-1651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT75235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty