Provider Demographics
NPI:1417033978
Name:MCKAY, JOY (PT)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:MCKAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 GALENA CT
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-9062
Mailing Address - Country:US
Mailing Address - Phone:406-542-7388
Mailing Address - Fax:
Practice Address - Street 1:1001 SW HIGGINS AVE STE 205
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1340
Practice Address - Country:US
Practice Address - Phone:406-721-3096
Practice Address - Fax:406-721-3956
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT567PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3401054Medicaid