Provider Demographics
NPI:1407085640
Name:CLAUSSEN, HOLLY PATRICIA (DPT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:PATRICIA
Last Name:CLAUSSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 HARVE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8332
Mailing Address - Country:US
Mailing Address - Phone:406-542-0808
Mailing Address - Fax:406-542-0909
Practice Address - Street 1:1940 HARVE AVE STE 2
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8332
Practice Address - Country:US
Practice Address - Phone:406-542-0808
Practice Address - Fax:406-542-0909
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist