Mae Baltazar, P.T.
Individual provider Active NPI Specialist · Livingston, MT
NPI 1487849568 · NPPES record last updated May 19, 2011
Key facts
- NPI
- 1487849568
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 40QA01208200 (NJ)
- Practice address
- 1201 US Hwy 10 W
Unit E
Livingston, MT 59047 - Phone
- (406) 222-5519
- Fax
- (406) 222-0366
- NPI assigned
- Sep 11, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01208200 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yellowstone Physical Therapy Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 40QA01208200 | NJ | Yes |
Addresses
Primary practice location
1201 US Hwy 10 W
Unit E
Livingston, MT 59047
Mailing address
1201 US Hwy 10 W
Unit E
Livingston, MT 59047
Phone (406) 222-5519
Other providers in Livingston, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2011. 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.