Provider Demographics
NPI:1174711360
Name:COMPREHENSIVE MEDICAL REHABILITATION SERVICES, PC
Entity type:Organization
Organization Name:COMPREHENSIVE MEDICAL REHABILITATION SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:GALVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-761-3767
Mailing Address - Street 1:914 13TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4406
Mailing Address - Country:US
Mailing Address - Phone:406-761-3767
Mailing Address - Fax:406-761-3038
Practice Address - Street 1:914 13TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4406
Practice Address - Country:US
Practice Address - Phone:406-761-3767
Practice Address - Fax:406-761-3038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7257208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000084119Medicaid
MT000084118Medicare PIN
MTE59237Medicare UPIN