Grant Damon Poor, M.S., P.T.

Individual provider Active NPI Physical Therapist · Fairfield, MT

NPI 1194740928 · NPPES record last updated Nov 14, 2025

Key facts

NPI
1194740928
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1258 PT (MT)
Practice address
15 6TH St S
Fairfield, MT 59436
Phone
(406) 467-3800
Fax
(406) 467-3828
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1258MTMDAddiction (Substance Use Disorder) Counselor
1258 PTMTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Physical Therapy & Sports Med Physical Therapist Past
since Mar 3, 2015
Accepting new patients
Brian D. McCollom, O.D., Inc. Past
since Jan 1, 2006
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1258 PT MT Yes

Addresses

Primary practice location

15 6TH St S
Fairfield, MT 59436

Mailing address

PO Box 457
Fairfield, MT 59436
Phone (406) 467-3800

Other practice location 1

915 4th St NW
Choteau, MT 59422-9123
Phone (406) 466-5763

Other identifiers

IdentifierTypeStateIssuer
60396OtherMTBC/BS OF MT
0340187MedicaidMT

Other providers in Fairfield, MT

All providers in Fairfield, MT · Physical Therapist in Montana

Sources for this page

Verify at the official NPI Registry.