Provider Demographics
NPI:1285289231
Name:CUTTING EDGE ORTHOPEDIC PHYSICAL THERAPY
Entity type:Organization
Organization Name:CUTTING EDGE ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:406-459-3903
Mailing Address - Street 1:370 GRIZZ AVE APT C
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-7489
Mailing Address - Country:US
Mailing Address - Phone:406-459-3903
Mailing Address - Fax:
Practice Address - Street 1:1221 ECHELON PL STE A
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-7695
Practice Address - Country:US
Practice Address - Phone:406-459-3903
Practice Address - Fax:406-646-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy