Provider Demographics
NPI:1598794414
Name:GILLET, LORI (LPT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:GILLET
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3985 VALLEY COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6633
Mailing Address - Country:US
Mailing Address - Phone:406-585-4642
Mailing Address - Fax:406-585-2878
Practice Address - Street 1:1648 ELLIS ST STE 101
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8811
Practice Address - Country:US
Practice Address - Phone:406-585-4642
Practice Address - Fax:406-585-2878
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1203PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist