Basic Information
| Provider Information | |||||||||
| NPI: | 1912355454 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESHLEMAN | ||||||||
| FirstName: | NOAH | ||||||||
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| Credential: | DPT, ATC, CSCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1701 HENDERSON CT | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750615531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146835749 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1302 PROSPECT AVE STE C | ||||||||
| Address2: | |||||||||
| City: | HELENA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 596013928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4065021900 | ||||||||
| FaxNumber: | 4065021333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2016 | ||||||||
| LastUpdateDate: | 02/17/2017 | ||||||||
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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 | 2251X0800X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 225100000X | 11120 | MT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.