Provider Demographics
NPI:1649480591
Name:FRIED, JASON D (PT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:D
Last Name:FRIED
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:325 SKYLINE DR NE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1024
Mailing Address - Country:US
Mailing Address - Phone:406-455-9898
Mailing Address - Fax:
Practice Address - Street 1:1800 BENEFIS CT
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4320
Practice Address - Country:US
Practice Address - Phone:406-771-4788
Practice Address - Fax:406-727-1324
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT12162251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic