Provider Demographics
NPI:1295487890
Name:HERTING, JILL E (DPT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:E
Last Name:HERTING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SMELTER AVE NE STE B
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1924
Mailing Address - Country:US
Mailing Address - Phone:406-727-2826
Mailing Address - Fax:406-727-3522
Practice Address - Street 1:203 SMELTER AVE NE STE B
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1924
Practice Address - Country:US
Practice Address - Phone:406-727-2826
Practice Address - Fax:406-727-3522
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-PRV-22102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist