Provider Demographics
NPI:1699987602
Name:STAHL, TORI (ATC)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:
Last Name:STAHL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 MT HIGHWAY 200 E TRLR 21
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-9579
Mailing Address - Country:US
Mailing Address - Phone:406-258-2873
Mailing Address - Fax:
Practice Address - Street 1:3100 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-5106
Practice Address - Country:US
Practice Address - Phone:406-728-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other