Jerad Paul Gillen
Individual provider Active NPI Physical Therapist · Box Elder, MT
NPI 1194944868 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194944868
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1499 (MT)
- Practice address
- RR 1 Box 664
Box Elder, MT 59521-9797 - Phone
- (406) 395-4486
- Fax
- (406) 395-5941
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1499 | MT | Yes |
Addresses
Primary practice location
RR 1 Box 664
Box Elder, MT 59521-9797
Mailing address
1165 Oak Dr
Havre, MT 59501-5433
Phone (406) 265-3448
Other providers in Box Elder, MT
- Sandra Marie Friede
- Karen Lynn Garland
- Michael James Geboe
- Meagan Elizabeth Geis
- Hailie Brooke George
- Angela Marie Gopher
- Brueshana Grant
- Natalie M Gray
- Trisha Lynn Greff
- Leanne Jayne Hanson
All providers in Box Elder, MT · Physical Therapist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.