Basic Information
| Provider Information | |||||||||
| NPI: | 1316914575 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINK | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1343 HWY 93 N | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062973915 | ||||||||
| FaxNumber: | 4062973364 | ||||||||
| Practice Location | |||||||||
| Address1: | 1343 US HIGHWAY 93 N | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 599179503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062973915 | ||||||||
| FaxNumber: | 4062973364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2006 | ||||||||
| LastUpdateDate: | 05/11/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1648 | MT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT9108 | TN | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2251X0800X | 1648 | MT | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.