Impact Sports Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

IMPACT SPORTS PHYSICAL THERAPY PC

Practice address

432 E Idaho St
Ste. 431
Kalispell, MT 59901-4137

Phone

(303) 902-5456

NPI assigned

Apr 2, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keith Eric Christiansen, PT, ATC, MTC

Title

Owner

Phone

(303) 902-5456

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1710372123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 E IDAHO ST",
            "address_2": "STE. 431",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 E IDAHO ST",
            "address_2": "STE. 431",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014137",
            "telephone_number": "303-902-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-902-5456",
        "authorized_official_credential": "PT, ATC, MTC"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Sean Iddings
• Ideal Option, PLLC
• Ideal Telemedicine Services LLC
• Kellie Catherine Ileto
• Immanuel Lutheran Corporation
• Cami Imperato
• Joshua Inabnit, LCPC
• Ann Kilburn Ingram, MSN, APRN, COHN-S
• David L. Ingram, MD
• Innovative Dental Solutions, PLLC

• Physical Therapy Clinic/Center in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Physical Therapy Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.