Provider Demographics
NPI:1730254608
Name:CLUTTER-COLLINS, DAWN MICHELE (PT)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MICHELE
Last Name:CLUTTER-COLLINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 2ND ST. S. SUITE 2
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1245
Mailing Address - Country:US
Mailing Address - Phone:406-770-3171
Mailing Address - Fax:406-770-3173
Practice Address - Street 1:900 2ND ST. S. SUITE 2
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4014
Practice Address - Country:US
Practice Address - Phone:406-770-3171
Practice Address - Fax:406-770-3173
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT548225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist