Provider Demographics
NPI:1215479472
Name:TROTTING HORSE THERAPEUTIC RIDING
Entity type:Organization
Organization Name:TROTTING HORSE THERAPEUTIC RIDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTORS
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-880-3417
Mailing Address - Street 1:1270 TROTTING HORSE LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-9770
Mailing Address - Country:US
Mailing Address - Phone:406-370-8477
Mailing Address - Fax:
Practice Address - Street 1:1270 TROTTING HORSE LN
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-9770
Practice Address - Country:US
Practice Address - Phone:406-370-8477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty