Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 290 | MT |
NPI | 1013183110 |
---|---|
Provider Name | Timothy G Redfern |
First Address | Hamilton, MT 59840-9216 |
Second Address | Hamilton, MT 59840-9216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 08/05/2008 |