Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 787 | MT |
N | 2251G0304X | Physical Therapist - Geriatrics | 787 | MT |
NPI | 1265765887 |
---|---|
Provider Name | Lori Ann Zundel |
First Address | Billings, MT 59102-6520 |
Second Address | Billings, MT 59102-6440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2009 |
Last Update Date | 15/09/2009 |