Provider Demographics
NPI:1396360830
Name:HUTCHENS, KEELY J (DPT)
Entity Type:Individual
Prefix:
First Name:KEELY
Middle Name:J
Last Name:HUTCHENS
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:PO BOX 5718
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-5718
Mailing Address - Country:US
Mailing Address - Phone:406-756-0134
Mailing Address - Fax:406-300-1612
Practice Address - Street 1:1302 PROSPECT AVE STE C
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3928
Practice Address - Country:US
Practice Address - Phone:406-502-1900
Practice Address - Fax:406-502-1333
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
ND2339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND2339OtherNORTH DAKOTA BOARD OF PHYSICAL THERAPY