Provider Demographics
NPI:1396803235
Name:HORIZON PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:HORIZON PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:406-825-6000
Mailing Address - Street 1:PO BOX 71, 20331 E. MULLAN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MT
Mailing Address - Zip Code:59825-0071
Mailing Address - Country:US
Mailing Address - Phone:406-825-6000
Mailing Address - Fax:406-543-1564
Practice Address - Street 1:20331 EAST MULLAN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MT
Practice Address - Zip Code:59825
Practice Address - Country:US
Practice Address - Phone:406-825-6000
Practice Address - Fax:406-543-1564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0003400215Medicaid