Provider Demographics
NPI:1053595512
Name:STEINBACH, GARY LEE (REGISTERED PHYSICAL)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:LEE
Last Name:STEINBACH
Suffix:
Gender:M
Credentials:REGISTERED PHYSICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-0565
Mailing Address - Country:US
Mailing Address - Phone:406-388-8723
Mailing Address - Fax:406-388-5092
Practice Address - Street 1:662 GLIDER LN
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-8367
Practice Address - Country:US
Practice Address - Phone:406-388-8723
Practice Address - Fax:406-388-5092
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist