GRIZZLY SPINE PAIN AND REHAB PC NPI 1104097351

NPI Information

NPI: 1104097351
Provider Name: GRIZZLY SPINE PAIN AND REHAB, PC
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

CLIA Number: 27D1094510

Address:
3 MERIDIAN CT
SUITE 2
KALISPELL, MT
ZIP 59901
Phone: (406) 755-4488
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GRIZZLY SPINE PAIN AND REHAB, PC is a pain clinic center in Kalispell, MT. GRIZZLY SPINE PAIN AND REHAB, PC NPI is 1104097351. The provider is registered as an organization entity type.

The provider's business location address is:

3 MERIDIAN CT
SUITE 2
KALISPELL, MT
ZIP 59901-240
Phone: (406) 755-4488
Fax: (406) 755-4481

The provider's authorized official is Scott Richard Jahnke .
The authorized official title is Doctor - Owner and has the following contact phone number (406) 755-4488.

The CLIA number assigned to this NPI record is 27D1094510 - mobile lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/17/2008 and was last updated on 4/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			No
2	261QP3300X	Clinic/Center	Pain	10947	MONTANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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