Phillip Leavell, PTA
Individual provider Active NPI Physical Therapy Assistant · Missoula, MT
NPI 1306064993 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1306064993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 1966 (MT)
- Practice address
- 4718 23Rd Ave
Missoula, MT 59803-1163 - Phone
- (406) 251-6410
- NPI assigned
- Apr 22, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7347A | AZ | MD | Physical Therapy Assistant |
| 1966 | MT | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1966 | MT | Yes |
| Physical Therapy Assistant | 225200000X | 7347A | AZ |
Addresses
Primary practice location
4718 23Rd Ave
Missoula, MT 59803-1163
Mailing address
100 Sage LN
Hamilton, MT 59840-3630
Phone (406) 375-2342
Other providers in Missoula, MT
- Kari Anne Leach
- Colleen Renae Leadbetter
- Lean in Recovery Mt
- Kassie Marie Leaphart
- Meredith Alexia Lease
- Jeffrey Todd Lebsock
- Nathan Thomas Lebsock
- David William Lechner
- Christopher Robert Leder
- Kendra B. Lee
All providers in Missoula, MT · Physical Therapy Assistant in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.