Provider Demographics
NPI:1215025861
Name:HERNDON, EMILY CHRISTINE (DPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CHRISTINE
Last Name:HERNDON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:CHRISTINE
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-0190
Mailing Address - Country:US
Mailing Address - Phone:406-826-4383
Mailing Address - Fax:
Practice Address - Street 1:200 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859
Practice Address - Country:US
Practice Address - Phone:406-531-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33130225100000X
MT2123225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist