Glacier Peaks Mobile Physical Therapy LLC
NPI 1457978983ActiveOrganization· Physical Therapist· Columbia Falls, MT
Physical Therapist in Columbia Falls, Montana, registered in NPPES in July 2020. The authorized official on file is Jacquelyn R. Bullock, DPT, Physical Therapist/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1457978983 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 1, 2020 |
| Last updated in NPPES | Jan 12, 2026 |
| Certified by provider | Jan 12, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Clinic/Center, Physical Therapy | 261QP2000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MT) |
|---|
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