Provider Demographics
NPI:1164867313
Name:JENKINS, JULIE DAWN (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:DAWN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:DAWN
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4739 MEADOW LANE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715
Mailing Address - Country:US
Mailing Address - Phone:406-586-2772
Mailing Address - Fax:406-586-2644
Practice Address - Street 1:298 PARKLANDS TRL
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-9375
Practice Address - Country:US
Practice Address - Phone:406-318-5055
Practice Address - Fax:406-219-0028
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-1573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist