Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PTP-PT-LIC-1549 | MT |
N | 2251N0400X | Physical Therapist - Neurology | PTP-PT-LIC-1549 | MT |
NPI | 1790932713 |
---|---|
Provider Name | Mrs. Amy Marie Downing |
First Address | Missoula, MT 69806-0935 |
Second Address | Missoula, MT 59801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2008 |
Last Update Date | 17/09/2020 |