Provider Demographics
NPI:1841322310
Name:YELLOWSTONE PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:YELLOWSTONE PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER, CORPORATE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:SCHRETENTHALER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CSCS
Authorized Official - Phone:406-222-5519
Mailing Address - Street 1:1201 US HWY 10 W
Mailing Address - Street 2:UNIT E
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047
Mailing Address - Country:US
Mailing Address - Phone:406-222-5519
Mailing Address - Fax:406-222-0366
Practice Address - Street 1:1201 US HWY 10 W
Practice Address - Street 2:UNIT E
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047
Practice Address - Country:US
Practice Address - Phone:406-222-5519
Practice Address - Fax:406-222-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT198225100000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTCG5577OtherRAILROAD MEDICARE
MTMSF 1117466OtherSTATE FUND WORKER'S COMP
MTMSF 1117466OtherSTATE FUND WORKER'S COMP
MTCG5577OtherRAILROAD MEDICARE