Provider Demographics
NPI:1962531772
Name:LINK, CAROL SHANDS (MSPT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:SHANDS
Last Name:LINK
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 SOUTH MAIN
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2017
Mailing Address - Country:US
Mailing Address - Phone:406-310-0296
Mailing Address - Fax:406-782-4956
Practice Address - Street 1:134 SOUTH MAIN
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2017
Practice Address - Country:US
Practice Address - Phone:406-310-0296
Practice Address - Fax:406-782-4956
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist