Provider Demographics
NPI:1366541948
Name:URBAN, CLARA (PT)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:
Other - Last Name:URBAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:PHYSICAL THERAPY DEPT UNIVERSITY OF MONTANA
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59812-0001
Mailing Address - Country:US
Mailing Address - Phone:406-243-4735
Mailing Address - Fax:
Practice Address - Street 1:PHYSICAL THERAPY DEPT UNIVERSITY OF MONTANA
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59812-0001
Practice Address - Country:US
Practice Address - Phone:406-243-4735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist