Provider Demographics
NPI:1609024983
Name:KENNEDY, HILLARI E (CMT)
Entity Type:Individual
Prefix:MISS
First Name:HILLARI
Middle Name:E
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 1/2 N BLACK AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3613
Mailing Address - Country:US
Mailing Address - Phone:406-209-3755
Mailing Address - Fax:
Practice Address - Street 1:2415 W MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3808
Practice Address - Country:US
Practice Address - Phone:406-209-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist