Provider Demographics
NPI:1447924519
Name:ADVANCED THERAPEUTICS OF MONTANA
Entity type:Organization
Organization Name:ADVANCED THERAPEUTICS OF MONTANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:406-794-2691
Mailing Address - Street 1:369 ARISTOCRAT DR APT 3
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-1405
Mailing Address - Country:US
Mailing Address - Phone:406-794-2691
Mailing Address - Fax:
Practice Address - Street 1:1500 POLY DR STE 206
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1748
Practice Address - Country:US
Practice Address - Phone:406-794-2691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty