Bailey Cooke, PTA

Individual provider Active NPI Physical Therapy Assistant · Missoula, MT

NPI 1912214735 · NPPES record last updated Sep 1, 2010

Key facts

NPI
1912214735
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2363PTA (MT)
Practice address
5000 Blue Mountain Rd
Missoula, MT 59804-9213
Phone
(406) 251-2323
Fax
(406) 251-2999
NPI assigned
Sep 1, 2010
Sex
Female
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

LicenseStateTypeSpecialty
2363PTAMTMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2363PTA MT Yes

Addresses

Primary practice location

5000 Blue Mountain Rd
Missoula, MT 59804-9213

Mailing address

5000 Blue Mountain Rd
Missoula, MT 59804-9213
Phone (406) 251-2323

Other identifiers

IdentifierTypeStateIssuer
1306858642OtherMTORGANIZATION NPI

Other providers in Missoula, MT

All providers in Missoula, MT · Physical Therapy Assistant in Montana

Sources for this page

Verify at the official NPI Registry.