Basic Information
Provider Information
NPI: 1831615426
EntityType: 2
ReplacementNPI:  
OrganizationName: PINTLER HEALTH & REHAB, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: PINTLER PHYSICAL THERAPY & SPORTS REHAB
OtherOrganizationType: 3
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 5718
Address2:  
City: KALISPELL
State: MT
PostalCode: 599035718
CountryCode: US
TelephoneNumber: 4067560134
FaxNumber: 4063092579
Practice Location
Address1: 110 MAIN ST
Address2:  
City: ANACONDA
State: MT
PostalCode: 597112252
CountryCode: US
TelephoneNumber: 4065630797
FaxNumber: 4065630796
Other Information
ProviderEnumerationDate: 08/16/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STIMAC
AuthorizedOfficialFirstName: BLAINE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO, MANAGING MEMBER
AuthorizedOfficialTelephone: 4067561128
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: PT
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y193400000X SINGLE SPECIALTY GROUPRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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