Provider Demographics
NPI:1134118730
Name:CORWIN, JOY W (PT)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:W
Last Name:CORWIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:R
Other - Last Name:WHITNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2119 10TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405
Mailing Address - Country:US
Mailing Address - Phone:406-452-0001
Mailing Address - Fax:406-453-6465
Practice Address - Street 1:2119 10TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:406-452-0001
Practice Address - Fax:406-453-6465
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT233PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0344333Medicaid