Jennifer Catherine Gruber, MPT
Individual provider Active NPI Physical Therapist · Shelby, MT
NPI 1457314445 · NPPES record last updated Aug 19, 2011
Key facts
- NPI
- 1457314445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1855PT (MT)
- Practice address
- 640 Park Ave
Shelby, MT 59474-1663 - Phone
- (406) 434-3234
- Fax
- (406) 434-3252
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010734 | MI | MD | Physical Therapist |
| 1855PT | MT | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1855PT | MT | Yes |
| Physical Therapist | 225100000X | 5501010734 | MI |
Addresses
Primary practice location
640 Park Ave
Shelby, MT 59474-1663
Mailing address
320 12TH Ave N
Shelby, MT 59474-1727
Phone (406) 450-3137
Other providers in Shelby, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2011. 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.