Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 4459 | MT |
NPI | 1194061572 |
---|---|
Provider Name | Kristen Louise Houston |
First Address | Billings, MT 59102-4344 |
Second Address | Billings, MT 59105-1834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2012 |
Last Update Date | 12/12/2012 |